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A Patient describes a recent conversation with his father. Once again, the patient is invited to join his father in financially providing extra resources for his younger siblings. Although the patient can afford to do this presently, the future looks extremely uncertain in his field. Of late, he has spoken often of his anxiety about his own financial security.
The patient recounts how he quickly agreed to help his siblings, so they would have the “peace of mind” of “extra reserves.” Then he becomes noticeably uninterested in going over the details of the plan with his father, and equally uninterested in exploring it in treatment. His summary, in a nonchalant voice, is a repetition of the word “whatever.” It wasn't that important.
The feeling I had was that this was a “fait accompli.” I wasn't, to question his acceding to the request. I wasn't to react as though this had much significance. I was merely to notice how his father assumed the patient hadn't needs of his own. Just as the patient was expected to unresistantly pay, I was expected to unresistantly accept he had no choice other than to go along with his father's plan.
What does this patient need most from me? Who must I be to help him? Can I be any competent analyst (harkening back to classical thinking, e.g., Freud, 1912)? Can I be any trained analyst able to “handle” her countertransference so it doesn't “disrupt” the process? Or are there human qualities, aside from technical competence, that are crucial to effective work with this patient?
In this clinical situation, I believe an important variable is my stance toward certain specific challenges in life. In what follows I claborate some aspects of my own development as a person that I think are relevant to my treatment of this patient. I see as central to this work the