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For some years now, I have been offering a time-limited psychotherapy to particular patients in the context of a private analytic practice. I shall give here a clinical vignette of an intervention with someone who, though domiciled in the UK, worked abroad and returned for a monthly stay two or three times a year. We were able to meet for two sets of five sessions. Having learned the precipitating reason for the referral, I agreed to set up a first session.
He arrived fractionally ahead of time. I led him straight into the consulting room. He struck me as someone who could readily disappear in a crowd, dressed in dark casual clothes, hunched into himself as if stiffened by arthritis, not tall, and fashionably unshaven. I directed him to one of the chairs and he perched on it. I asked him what he wished to work on. He told me he had asked to be referred following successful cancer treatment one year earlier and having just been medically confirmed as symptom-free. Despite all assurances, he still felt uneasy. He had been treated by ‘the best man in the country’ for his complaint who had given him the all clear and yet the part of the sentence that constantly rang in his ears was: ‘But, of course, there could always be the one rogue cell’. The thought invaded all his waking hours and the only way he had of controlling it was to work obsessively, but he feared he might eventually drop from exhaustion.
Observing my initial response, I had the feeling he had brought his disabling fear to me and that I, knowing how briefly he would be in the UK, felt acutely pressured to decide whether I had anything to offer in a time-limited modality or was the whole enterprise doomed. He may have picked up my hesitation and told me that 20 years ago he had had four times a week psychoanalysis over three years with Dr S, of whom I had heard but did not know personally. He felt that thanks to him he was able to progress in his career. I too felt grateful for this information as I was able