Response to Jackie Gerrard

I would like to make a few comments on Jackie Gerrard's very interesting article, ‘Ocnophilia and the interpretation of transference’ (BJP 16(4): 400-411).

I do not think there is really such a great difference in approach between Gerrard and Balint, but what is most encouraging about Gerrard's views and her account of her own clinical practice is that they show just how much analysis has moved on since 1968. It seemed to me that the reason Gerrard found herself disagreeing with Balint was because his idea of what constituted a transference interpretation was probably very different from current ideas and practice. In the Balint example she quoted, I would have thought that what Balint said to his patient was a transference interpretation, albeit it was couched in the form of giving his reasons for not acceding to the patient's request for an extra session. He seemed to think that transference interpretations were purely directed to unconscious libidinal drives and therefore bypassed the patient's actual need of the therapist. In the language of self-psychology, Balint's objection was to interpretations which are ‘experience-distant’ at a point when what the patient needs above all is recognition of their need in the moment. This kind of recognition was precisely what Gerrard's own clinical examples demonstrated.

In her first example, it was not only through interpretation but also through her action of offering an extra session that the patient felt held and understood. (There are interesting issues about the frame here: was the extra session that Gerrard offered different from the one Balint's patient requested because it was a regular session - and thus an extension of the frame rather than a breaking of it - or is there some inherent difference between a Thursday session and a weekend session? Perhaps our ideas about the sacrosanct nature of weekends have also changed since 1968?) Throughout the article, Gerrard argues sensitively and with great warmth of feeling