Response to Sandra Buechler

I welcome Sandra Buechler's shared interest in the analyst's deep emotional experiences, which she has written about extensively elsewhere (Buechler, 2004). She is unabashed in her “romantic” view of the analytic process, favoring emotional experience over a rigid professional persona. I agree when she says that what gratifies us is both universal and unique to our own personalities, early experience, and training. I also agree that my paper would benefit from a deeper discussion of the meaning of “gratification.” I just simply couldn't figure out a way to attempt that discussion without digressing too much from the basic thesis I was presenting.

What I can add at this point, after reading Dr. Buechler's discussion and rereading the paper, is that I am talking about two essential levels of gratification. The first is the one required to keep the analyst satisfied enough with the relationship to stay engaged and actively participating day-to-day. The other level of gratification is the broader one that is the major thesis of my paper—that a similar, ongoing, transformative experience will necessarily occur within the analyst as it is facilitated for the patient. (The topic of the toxic patient or the toxic analyst who transform the other for the worse is yet another issue to be explored.)

Again, I am not saying that the degree of transformation will be equal to the patient's. I think a totally mutual transformation is unlikely, if for no other reason than that it is the patient's life that is the subject of the treatment. Yet I can honestly say that I have been significantly transformed as a result of treating certain of my patients, and am grateful for the experience. In other cases, I find the change in me is quite small. Some changes are dependent on the patient's presence in our lives, which may account for some of our reluctance to release certain patients and facilitate their terminations.

Buechler says she finds it helpful to consider the emotional impact her pat