A Patient Returns: Discussion

Whatever the other motivations, a serious analyst analyzes in order to learn how to analyze. Candidacy is the start of training, not its end. Thus, the question of what works better clinically and what less well is always on our minds. Our professional lives demand a self-supervision, and with it a self-analysis, that never ends.

Aware of the power of self-delusion, we know the wisdom in the tennis coach's old saying, “Practice makes permanent.” Long practice can lead to growing skills, but merely repeated, experience can also lead us to call something growth that in fact is only personal comfort.

As a result, we seek outside checks on ourselves. Ideas of regular return to personal analysis or formal supervision live more in our literature than in our actuality. Peer supervision certainly helps. Looking for more, we ask what could make more sense than to turn to those who know how we work better than anyone else—our patients.

Indeed, during the course of analytic work, our patients, eager to get better whatever the power of their disorders, endlessly press us to do better. Perhaps most often nonverbally, they do what they can to teach us to become the analyst they need. Our studies of the analytic process have been too blind to the extent to which during the course of their analyses it is our patients who inform us and influence us on what they need in their analyst. That is an essential process that lies hidden in the shadows of everyday analytic work.

What could be more logical than to see what can be gleaned not from the muddle at the middle of an unfolding analysis but from patients who return afresh after long interruptions? What could be more straightforward than that our returning patients identify for us failures in our technique, taking a role like that of the unsatisfied customer who returns to tell the tailor, “Sam, you made the pants too long”?

If only it were so simple, so measurable. If only “postanalysis” were so quantifiably objective a “transference/coun