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WHILE REREADING MY PRESENTATION AND DISCUSSION of the therapeutic process in this paper, I thought that I might have conveyed the somewhat misleading impression of having understood things earlier and more easily than was actually the case.2 During its first two years, I experienced this treatment situation, for the most part, as exceedingly dull and confusing. The experience was mitigated only by the fact of the patient's making what appeared to be good and steady therapeutic progress. I had little more in the way of understanding than the sense that in accepting things as they were I was probably meeting some basic therapeutic need in my patient. My understanding only gradually gained in clarity, aided by certain concepts from the work of Melanie Klein (1946), (1951), Racker (1968), Winnicott (1958), (1965) and Spotnitz (1969), (1976). In general, I have found these writers helpful in enabling me to make some sense of difficult treatment situations involving patients who present primitive mental states. I have for some time been assimilating certain of their contributions into the core of my psychoanalytic understanding which had been established in my training at the Wm. Alanson White Institute.
The more recent influences are perhaps more apparent in the presentation than are the earlier ones. Yet Racker did cite as one of the important factors determining the multiple technical variations and divergencies in psychoanalytic practice, "the genealogic factor, that is to say, the influence of different 'archifathers' and 'fathers' upon the technique of their analytic children, grandchildren and great-grandchildren" (Racker 1968, p. 25).