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CONSIDER THE FOLLOWING HYPOTHETICAL SITUATION: It is the first session with a patient about whom I know very little—schedule and fee arrangements have already been made, and I have told him what I usually tell a new patient about how the therapy will proceed—and midway into the session he announces that he is writing an autobiography for me. These, let us imagine, are his words:
After I spoke to you on the phone last week and we made the appointment for me to begin psychotherapy today, I sat right down and began writing my autobiography for you. I've been working on it for about an hour every evening before I go to bed; and I figure it should take me another few days to complete it. So I'll give it to you next time.
How I respond to the announcement, and then to the issues that my response can cause, will depend on the kind of psychotherapy I intend to conduct1; and that intention will be determined by two sets of considerations: (1) who the patient is and what his circumstances and reasons for seeking treatment are; and (2) what my professional convictions are with respect to the optimal form (or forms) of psychotherapy. If I intend to conduct as classical a psychoanalysis as possible, for instance, I would most likely regard a written autobiography to be dissonant and inappropriate. I would want to know the meaning and significance of the patient's decision to write one for me, but I would not want to take a noncommital attitude towards such a serious deviation from the procedure of psychoanalysis; and therefore I would probably tell him that for me to read his autobiography could be a a significant departure from my preferred way of conducting treatment. Similarly, if I intend to establish an active and authentic relationship with the patient—according to certain interpersonalist or existentialist principles, for instance—I might regard