Shame/Contempt Interchanges: A Frequent Component of the Analyst-Patient Interaction

The task of this panel was to go beyond the topic of shame to address its much less scrutinized interrelation with contempt. Although the subject conjures up psychodynamic formulations concerning the component instincts of sadism and masochism, no such paired opposites, or the unconscious fantasies linked to them, were invoked by the title of the panel. Instead, the words interchange and interaction emphasized the reality of interpersonal activity and left to the panelists any psychodynamic explanations for what was observed. The very pairing of these two affects, however, posed questions concerning the place of aggression in human development, the dynamics and mechanisms involved with role reversal in the history of an individual's object relations, the relation of observed affects to functions of defense and to unconscious fantasy, and the place of projective identification.

Joseph Lichtenberg, the first panelist to present material, described observable interchanges, emphasizing the subtlety not only of the patient's possible expression of shame, but of the responsive presence of contempt, frequently unacknowledged, in the analyst. “In any dyadic relationship,” he contended, “one person's persistent shame is apt to trigger contempt in the other.” He suggested that shame and contempt can emerge in the patient as responses to the analyst's subjective limitations and that both feelings, in either member of the dyad, tend to be enacted if they go unrecognized by the analyst. It is important, he