Engaging Psychoanalytic Disequilibrium While Being More Human Than Otherwise: A review of Coasting in the Countertransference: Conflicts of Self-interest between Analyst and Patient, by Irwin Hirsch, 2008,  Analytic Press,  220 pp.

The conflict between analysts' listening to patients and being influenced by them, and listening to and being motivated by our own private desires, is ubiquitous” (p. 50, italics added). “[A]nalyses are never conducted in a standard way, though explication of analysts' selfish interests

and other personal qualities that help make each analysis unique is generally underaddressed in [the] psychoanalytic literature” (p. 31).

With no small measures of profound honesty and revealing personal candor, Irwin Hirsch has undertaken to logically extend contemporary psychoanalytic notions of the ubiquities of narcissism, unique individualities, and irreducible subjectivities as these phenomena are interpersonally lived out between analysts and patients to a variety of outcomes. Writing in the traditions of Harold Searles, who ruminatively and melan-cholically suffered his psychoanalytic shortcomings and focused on their contributions to his clinical work, and Sándor Ferenczi, who diarized his clinical difficulties in an attempt to capture their origins in his unique personal equation, Hirsch is unsparingly forthright in his evocative observations and explications of his sense of failing his patients. He focuses a discerning eye on his sense of falling short of his psychoanalytic ideals and, in so doing, sheds both heat and light on an impressive array of contemporary psychoanalytic concerns. In this eminently worthwhile undertaking, Hirsch permits, encourages, persuades, and demands that analysts reflect honestly on their all too human inclinations to reconcile the inevitable tensions between their own self-interests and those of their patients—to the detriment of the analytic project at hand.

Beginning with the book's title, Hirsch not only lays out the main theme of his thesis—conflicts of self-interest between analysts and patients—but also introduces the felicitous phrase “coasting in the countertransference. “ This apt expression is just one of many: Hirsch refers, for exa