Female-Male, Doctor-Patient: Discussion of Elizabeth Seward*

I AM NOT EXACTLY an unbiased discussant of Dr. Seward's essay. I was one of her supervisors during her analytic training (though I did not supervize her with the patient she presents here). In this paper she makes herself very vulnerable with her patient and with her reading audience, just as she did in supervision. I remember her as among the most honest, open, dedicated, and self-reflective analytic candidates with whom I have had the pleasure to work. In this context, I am invited to discuss this powerful essay perhaps because she has made herself so vulnerable in presenting the material. This is her first analytic training case, she had little experience as a psychotherapist, and was in the process of struggling to effect a transition from being one kind of a doctor to another very different kind of a doctor. She exposes her work with a man who benefited considerably from their relationship, seemingly paradoxically, in part because of the many “errors” she believes she made along the way. Most of us would not be as intrepid: verbatim transcripts that display being seduced in the context of a highly sexualized male-female relationship, decisions about physical boundary that run counter to the psychoanalytic norm, and open expressions of countertransference anger and outrage. The good news is that her patient grew as a person, Dr. Seward expanded as an analyst, and we readers once again have the opportunity to learn that productive analytic work, like any important relationship in life, never proceeds smoothly. Edgar Levenson (personal communication) often notes two pertinent aphorisms: “We are paid to be vulnerable,” and from Harry Stack Sullivan, “God save us from an analysis that is going well.“

As we all know, it is very easy to examine the work of someone else