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On a cold, bright afternoon in mid-February almost 3 years ago, my analyst announced at the beginning of our Monday session, “I have bad news about me.” He was smiling, or so I thought, so I smiled, too. “What's up?” I asked.
Now, somewhat more soberly, “I've been diagnosed with lung cancer, and it looks like I may have some complications. We don't know how bad it is yet, but I'm meaning to do all I can to beat this.” Oh my God, I thought. I did not, of course, speak out loud. This is really serious. But he looks fine. How bad can it be? Four and a half months later he was dead.
Illness in the Analyst is a rare collection of articles and papers—written mostly from the perspective of analysts of adult patients—on the repercussions of their being suddenly struck with serious illness. The editors scoured the scant literature, which is reviewed by Schwartz in the middle of the book, and have included articles from as early as 1982 (Abend & Dewald). Schwartz states that becoming seriously ill may activate powerful fantasies of punishment, mutilation, and abandonment, and that the fact of physical injury, or of bodily impingement by surgery, may evoke fears from the Oedipal period or earlier. He describes the ill therapist, in fact, as experiencing a “rent in his own intrapsychic ‘container.’“
The stories in this book are very personal, describing the illnesses as they happened, the analysts' emotional reactions at the time, as far as they were aware, and their subsequent self-analyses of the defences of denial, disavowal, and intellectualization.
Arlow, who actually dictated a description of the events of his illness immediately following it, describes in clear detail a series of heart attacks he endured, his losing consciousness over and over—and yet how well he felt throughout. On rereading his notes some years later, he comments, “I was struck by how strong was my need to deny the gravity of my illness and how this tendency was buttressed by my adopting an ‘analytic’ a