Introduction: A Patient Returns

It is a long-standing tradition in our field for analysts not to initiate contact with former patients. Unless a patient returns for consultation or additional treatment, the analyst has no follow-up information on a treatment. This results in a feeling that all analysts know well: frustration in not knowing how their patients have fared after analysis. How have their lives turned out? Did they sustain the gains they were able to make in analysis, or was there a falling back? Did they continue the work on their own and find solutions to some of the issues that remained unsettled, or only partially settled, at the end of treatment? What about their relationships? Have these improved and become more satisfactory as a result of the analytic work? How, overall, do they now view their analysis? Do patient and analyst see it the same way or very differently? And what role, if any, does the former analyst play in their lives and psyches? Does he or she continue to be a living presence, someone whose voice they still hear and who, in their imagination, they consult with from time to time, or has the analyst become a figure from the past, someone whose voice and image have faded from consciousness? And, finally and perhaps most important, what can analysts learn about their own work, and the analytic process more generally, from obtaining a follow-up of patients they have treated?

In many cases, such questions about former patients remain unanswered. Not only is this a major frustration that analysts must live with; it is also a major impediment to the effective study of the analytic process and the results of analyses. It is for this reason that a number of our colleagues, notably Pfeffer (1961), Schachter and Johan (1989), Oremland, Blacker, and Norman (1975), Kantrowitz (1986), Wallerstein (1986), and Erle and Goldberg (2003), as well as a number of European authors, have conducted follow-up studies. Usually these are not done by the treatment analyst but by a colleague wh