You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
SOMEONE ONCE ASKED PABLO PICASSO who was the greatest painter. And he replied, "On what day?" That is, in terms of difficult patients, we ought to know who's being difficult with whom, under what conditions, in what way, and to what ends. Recently there has been a surfeit of panel discussions and symposia on the difficult, the borderline, the narcissistically oriented, or those with primitive mental states. One wonders whether this is a new syndrome which we have just recently discovered, or whether it's all a healthy attempt on our part to extend, quite legitimately, our area of influence, and to come to terms with working with those patients who present themselves for help, but who do not seem to conform to a set of rules which some people hold dear.
As a matter of fact we might ask the question, do the difficulties reside in the patient or in the analyst, or better, in the interaction to which both contribute and for which both are responsible?
Perhaps it isn't the word "difficult" which we ought to consider but the word "the." Since as soon as we hear the attribution "the" attached to any appellation, diagnostic category, or social group, we are listening to a reification. We reify in any kind of interaction when we impersonalize or abstract the other, whether that interaction is conducted in the name of science, for purposes of so called