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I very much appreciate the generosity of the clinician in offering this interesting material for comment. Inevitably, a brief history and single session must leave out much from a therapy which has been ongoing for several years. In approaching it, I am interested in what might be the most immediate transference/countertransference dynamic at this point and in how that might be apprehended not only in the session but in the presentation as a whole.
On reading and rereading the material, I found myself with many questions: why this patient and why now? Has some nodal point been reached, that the therapist chooses to present him to us now? How many years is several - is it four or ten, or more? Where does the patient come in his family? What are his relationships like with his mother, his father, his siblings, beyond his enormous struggle to establish a life of his own? What does ‘a complex Holocaust history’ mean? Naturally, some of this detail has been omitted for the sake of brevity and to protect the patient's anonymity and I felt, especially with my last question, that I was perhaps