Psychoanalysis and Psychotherapy1

Last year this panel attempted to approach the concrete problem of how the choice of specific psychotherapy in individual cases is determined. We discussed the thesis that in actual fact the patient tries to make the therapist meet his conception of his needs, and that when real movement takes place the therapist does enter the needed reciprocal role, but continues it in a productive new direction. The therapist is thus the second variable in the equation; hence, the topic of the dynamics of his participation.

But to study the patient is relatively easy—it is our daily job—while to study the therapist is ticklish business, and tends to be systematically slighted in case presentations. The writers hesitate to be too self-revelatory of their own feelings and involvements and are fearful of being regarded as too "dramatic" according to the canons of sober scientific papers if they give the true flavor of the actual interchange in the therapeutic relationship. Yet, as Adelaide M. Johnson summarized in her introductory remarks, "What can we do better than to expose the living bilateral treatment experience to our colleagues, to everyone's eternal benefit? … Everyone of us knows that 70 per cent of the therapeutic operation never appears in most of our papers." Not merely "countertransference" problems, but the whole dynamic of the therapist's participation was our ambitious goal.

Sydney G. Margolin undertook the task of delineating the general background of the psychology of the psychotherapist, working both from the available literature and from conversations with about forty analytic colleagues. (These data were not statistically treated.) He utilized the metapsychological format, looking first at the genetic and dynamic factors in the therapist's choice of his role. He noted the general view that the same psychology characterizes the patient and the therapist, the essential factor distinguishing the therapist being his ego