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CONTEMPORARY PSYCHOANALYSIS considers that the transference screen upon which patients project their latent lives is and needs to be, in the fullest sense, a living and breathing one. Among the many personal variegations that constitute each analyst's screen and which serve as an evocative nidus for patients' fantasies is the physical health of the analyst. This unique and changing characteristic of each practitioner's functioning also has meaning for the analyst and impacts on the analyst's ability to discern meaning, a point stressed by Dewald in his opening remarks. The long-standing and resounding silence in the field about an issue as commonplace as analysts' becoming ill has been attributed to a host of factors particular to the practice of analysis: the privacy of the work; the temptation to attribute critical self-observations to projections of patients' guilt; and a narcissistic idealization of analysis, intensified by illness, that reinforces a fantasy of analytic "immunization" from the affects associated with life's disruptions.
That there are specifically "analytic" explanations for the profession's "conspiracy of silence," Dewald continued, is itself reflective of the wish to avoid recognizing the ultimately quite human desire to deny one's mortality and helplessness. Freud's failure, at least in print, to share his own struggle with his illness may have deprived the field of a supervisor with whom to identify who otherwise could have reduced the seductiveness of professionalized denial and grandiosity.
Beginning in 1982, with Dewald's (1982) article on the impact of his illness on himself and his clinical work a number of articles (Abend, 1982); (Schwartz, 1987); (Silver, 1982) and two books (Fenster et al., 1986); (Schwartz and Silver, 1990) have been published. These contributions have both reflected and contributed to a reduction in