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I am pleased and honored to have been asked to discuss this excellent article by Kathryn Zerbe. Its theme, announced at the outset, involves two notions: that of the secret and that of somatic disorganization in the patient and somatic signals affecting the psychoanalyst through the countertransference. As a French psychoanalyst and psychosomatician of the Paris School of Psychosomatics, I am particularly sensitive to the concept of “embodied countertransference” used, or perhaps created, by Zerbe. Like her, I believe that countertransference concerns the body of the psychoanalyst, who must let him- or herself be guided by somatic feelings.
I must say at the outset that the clinical examples in the article are remarkable. In addition, the review of the psychoanalytic literature is thorough and well-documented.
I would add here only a text by Pierre Marty (1952), which I translated and commented on in IJP under the title “The Narcissistic Difficulties Presented to the Observer by the Psychosomatic Problem.” This strictly theoretical text comprises Marty's observations and reflections on the psychosomatician's countertransference toward the somatic patient, even in theory.
Due to his illness, according to Marty, the somatic patient has a fragmented representation of his body, as well as a tendency to suppress the quality of the otherness of the object he is relating to. These particularities of the patient's mental functioning result in a modification of the psychoanalyst/psychosomatician's countertransference.
A double identificatory process develops in the analyst: on the one hand, he is led to experience intimately, through identification with his patient, the destruction of his body and the alteration of his image; on the other hand, he is subjected unconsciously, by his patient, to a movement