Commentary 11

The analyst reports two sessions from the early stages of an analysis with Amanda, a 32-year-old woman. The beginning of the analysis is taken up with a continuing dispute over the positioning of tissues in the treatment room. Exploring the problem from the classical analytic perspective is leading nowhere and the analysis does not really seem to be getting under way. Amanda finds the situation humiliating. She does not want to bring tissues of her own, asking what the analysis would then be all about. The scene is dominated by an urgent wish, which is Amanda's persistently expressed conviction that the analyst should take care of his patients and put tissues in the place where they are needed. An impasse seems to have been reached, but the situation is then resolved by two changes. Amanda stops complaining and instead wonders aloud whether she can still ask the analyst to place the tissues next to the couch. This reflexive meta-position in relation to her own wishes seems to have given the analyst some more room for manoeuvre as well. He then recalls a third person, namely Joseph Sandler, and the way in which he dealt with tissues. After this, he is able to acquiesce to Amanda's wish. However, this solution, which constitutes a new experience for Amanda with her analyst, is not analysed any further. I believe that Amanda is unable to make productive use of the analysis as long as she subjectively experiences her analyst as neglectful and in so far as she remains unable to draw a distinction between the real person and the transference. The analyst also seems at this stage to be strictly following the analytic rules for exploring clinical material, which makes him appear distant to Amanda, which she again experiences as neglectful.

Amanda comes across as narcissistically fragile, with a pronounced sense of personal inadequacy. Every comment that she makes about herself seems to reflect a shame reaction at the latent level. She repeatedly falls into a state of inhibit