Commentary 2

Before discussing this rich clinical report, I would like to say something about the position of the ‘outside’ commentator. Whatever perspective it affords, it can never take full account of the context of the analyst's words and other actions. That context always includes the whole of the analyst as a person and the whole of his/her sense of the relationship with the patient at any given moment. That ‘whole’ is always more than what the analyst can put into words for him/herself much less for others. For that reason, any commentary from the outside has to be qualified in terms of its relevance. It is always something for the practitioner to take into consideration and to adapt in his/her own creative and individually expressive way in the course of any ensuing new and, therefore, unique clinical moment.

My comments are addressed largely to consideration of a sample of opportunities that I see emerging in this case for engaging the patient in a way that has a chance to encourage differentiation of old, constricting tendencies from the healthier, more open and expansive potentials of the present, particularly the potentials of the present experience with the analyst. The process as reported seems to reflect progressive movement toward greater affective openness, and the analyst is often the catalyst promoting that development accompanied by new insights into the patient's resistances to it. There are a number of places, however, where I believe that a certain standard analytic attitude interferes with the analyst recognizing 1) the tension between the old patterns and the new possibilities; 2) his own partial complicity in the perpetuation of the old entrenched ways; and 3) his own power to foster the realization of new nascent potentials. As a result, I believe less is accomplished in regard to promoting the patient's sense of self, including her capacity for relational engagement, than what I feel lies within the reach of the participants.

In following the process in