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Presenter: When I started with this patient four and a half years ago, it was my first analytic case. I saw him five times a week for four years; since I came to live here I have been seeing him twice a day on two days a week. During the whole of the time I have been treating him I have been doubtful whether I would ever be able to become an analyst – he always made me feel very insignificant, and besides my own problems his behaviour confirmed my fears. I want to raise this question: why does this patient make me feel like that?
The motives that brought him to analysis were twofold: he was going to work as a publicity agent – he said he usually destroyed everything he most loved, and this agency was something he had always dreamt of doing all his life; and he had a bad relationship with women.
Bion: How did this patient come to you?
P: Through the Institute of Psychoanalysis.
B: We don't know what he had heard about analysis beforehand, but patients frequently feel that the analyst knows very little about it. You yourself may know that you don't know much about it – it would be very extraordinary if you ever thought that you did. If you ever think that you know much about analysis, you can be reasonably sure that you are deteriorating.
P: Then I am happy!
B: It is often helpful to go to the very thing which obtrudes: if you feel that the patient is able to make you feel guilty or frightened or anxious, that is what you need to investigate.
P: Should I cope with it in my own analysis, or with my patient?
B: There is no reason why you shouldn't take up the point with your own analyst, but I think it is a different matter with the patient.
Wanting to be analysed is a different state of mind from analysing somebody else. The two states may look the same, and if somebody was able to record it, it would sound the same, but they aren't.
There are many people who regard doctors and surgeons as inferior creatures. After all, it is a situation which has a long history; in England