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I AM DELIGHTED TO BE DISCUSSING Dr. Silver’s article. I first met Dr. Silver about ten years ago in Washington, and I was immediately taken with her clinical thinking and her wonderful lack of pretense. We sent each other reprints, and I was startled that although we had never had a clinical discussion, we had come up with similar ideas about working with psychotic and borderline patients. I realized how connected we were, through our heritage in the interpersonal tradition—hers in the Washington area and mine in New York. Both of us had teachers who studied and worked with Frieda Fromm-Reichmann and Harry Stack Sullivan.
I have always appreciated Dr. Silver, not only for her no-funny-business approach to clinical work, but also her openness, forthrightness, and personal warmth, all qualities that I am sure can be sensed in her presentation. She inspires me to speak personally, and I will do so. I also want to make special mention of Dr. Rose Spiegel, our dear colleague who died last year. Rose was especially skilled in working with psychotic patients, and her way of working was very related to Dr. Silver’s, as I will show here.
I am grateful for Dr. Silver’s comments on the kinds of competitiveness and showing-off that can go on during psychoanalytic clinical conferences, and that were endemic in the early years of Chestnut Lodge. These dynamics are hardly unknown to us at the White Institute. Some of us have compiled a list of the usual devastating comments that are often bandied about. My favorites are the following: “What you are doing is not analysis”; “You’re not paying enough attention to the patient’s aggression”; “You are missing something important in what the patient is telling you.” All these statements could almost always be true. After all, can you ever prove or disprove that what you are doing is analytic, that