The Analyst under Stress: Issues of Technique

Two articles in this issue raise questions of analytic technique at times when the analyst comes under personal life stress. The experiences reported here, involving pregnancy and illness in the analyst, were in each case consciously acknowledged by the analyst as stressful. The major issue is whether the analyst should talk with the patient about the stressful experience and, if so, when and to what degree. These questions, of course, involve the analytic principle of anonymity.

A traditional conception of anonymity sets limits to what the patient is allowed to know about the analyst's personal life; ultimately, these limits are purely arbitrary. Analysts' behavior indicates that we find it acceptable for patients to know our gender and approximate age, and to see our waiting room and office, our magazines and periodicals, our clothes, our stationery, our cars, and, if we practice at home, our house, including art and furnishings. Whether or not we disclose our religious views, patients know whether we work on Yom Kippur. Yet while analysts are not required in the name of anonymity to conceal these aspects of their lives, other aspects are clearly expected to be kept hidden. Analysts seem for the most part to agree that patients should not see the analyst's spouse or children, know what books and movies the analyst enjoys, or be told the analyst is under life stress.

The rationale for invoking the principle of anonymity in analytic treatment was based originally on a one-person model of treatment and has not been reexamined in the light of the widespread shift to a two-person model. Interestingly, Mosher's Key Word Index, which covers seventy years of the analytic literature, reports not a single journal article in which “anonymity” appears in the title (though eleven titles appear that include the word “neutrality”). In the one-person model, the less clear the patient's image of the analyst, it was thought, the clearer would be the patient's projection of transferen