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I WAS CONFRONTED with the issue of serious illness several years ago when a lump in my breast was diagnosed as an early stage of breast cancer. I underwent several outpatient procedures during the month after the initial biopsy, which necessitated my canceling and rescheduling sessions with some patients. Treatment for the cancer included chemotherapy and radiation, administered over a course of approximately eight months. My appearance changed; I lost my hair as a result of the chemotherapy and wore a wig.
A personal crisis causes a disruption to the state of ongoing regularity and relative predictability of one's life. It is a time of acute emotional disequilibrium in which the boundaries that people set up to protect themselves are bombarded by the presence of immediate situational stress. Psychoanalysts must contend not only with the explosion of the regularity and dependability of their personal life caused by the crisis, but also with the anxiety of disruption to their patients. The crisis fires questions that need to be immediately answered. Will patients' sessions need to be canceled? How will the cancellations be explained? What, if anything, should patients be told about the reasons behind the disruption to the predictability of their scheduled appointments?
How much explanation an analyst might offer to a patient is largely influenced by the analyst's theoretical orientation. The classical position, that patients be shielded from the analyst's personal life in order to protect the natural unfolding of the transference (see the literature review that follows), has been generally accepted until recently. Gradually, since the late 1960s, there has evolved a growing body of writing from within the interpersonal-relational analytic perspective that differs from this