An Analyst's Multiple Losses: Countertransference And Other Reactions1

THERE IS A WIDE ARRAY of events in the life of the psychoanalyst sufficiently disruptive to his or her psychological equilibrium to inevitably produce some impact on the conduct of analysis. These include pregnancy, miscarriage, separation and divorce, aging, severe illness and death of family members, financial reversals, major dislocations in place of residence or work, and the analyst's illness, related pain, disability, or death. There is little doubt in my mind, and in the view, I think, of most contemporary analysts, that such events affect analysts in a variety of complicated ways and to some extent accompany them into the psychoanalytic hour, perhaps most frequently affecting the analyst's contact with and experience of the patient's subjectivity. All such reactions, insofar as they affect the way the analyst thinks, the coloring and ambience of the analyst's participation in the analysis, might be considered manifestations of countertransference, in the broad rather than the narrow sense.

Over the last decade in particular, numerous articles have appeared about the impact of the analyst's illness on the process of psychoanalytic psychotherapy or psychoanalysis, with particular focus on the relevance to countertransference (Abend, 1982) ; (Dewald, 1982), (1992) ; (Goldberg, 1985) ; (Gurtman, 1990) ; (Halpert, 1982) ; (Lasky, 1990) ; (Little, 1967) ; (Rosner, 1986) ; (Schwartz, 1987) ; (Shapiro, 1985) ; (Silver, 1982) ; (Van Dam, 1987). In addition, there is at least one book on the subject (Schwartz & Silver, 1990). Much of that literature deals with whether and how to inform one's patients of the circumstances and, if so, with what content and timing. That literature also deals extensively with issues posed by the analyst's need to reduce high levels of stress, the wish to be soothed and comforted by patients, and the use of patient's traumatic experiences as