Two and a Half Cheers

Sir,

Congratulations on the first edition of the new Journal.

The clinical commentary was fascinating with each of the discussants raising interesting points on the case presented. Yet, regardless of the different theoretical perspectives which emphasize various aspects of the case and particularly of the

patient's psychopathology and experience, I notice a significant similarity in the comments on the therapist's input; ‘… the almost compulsive interrupting style the therapist found himself adopting’ (Samuels, p. 81); ‘The therapist's irritation and impatience is evident in dealing with the patient during this session’ (Boutall, p. 85); ‘It is, as we are shown, very difficult not to react with impatience and in that way get caught up in acting out the active role in the relationship’ (Jackson, p. 88).

I hope this is evidence of a basic agreement on the importance of fully conceptualising the interactive nature of the therapeutic relationship, and I wonder if I could add a few words about the therapist's contribution to the communicative network developed by both patient and therapist in this session because perhaps it ultimately gets less attention than the patient's. It is important, for example, that in the summary of the previous session to that reported, only the patient's communications are given. Should we assume the therapist was silent? Probably not, because this would very much contradict the style commented on so unanimously in the reported session. We do know that the therapist felt pushed out and ignored (‘very little space or attention for my interpretations’) and had been told by the patient that his symptoms had returned ‘which by implication was a very disheartening occurrence’. To whom - only the patient, as implied? Eventually the general complaint about ‘the way analysts talked’ is voiced. So the patient is calling attention to precisely the issue noticed by all three commentators.

I would imagine that this therapist might have been feeling angry,