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(Accepted for publication 26 September 2014)
The author's outline of the model of the psychoanalytic process is admirably clear and convincing. However, I find myself less agreement with the way the model is applied to the fascinating clinical material and the interaction with the analyst she presents.
The clinical vignette begins with the first session of the week in which the woman patient, a junior academic, says she has been thinking all the way to the session about being left out of the departmental Christmas party. There had been no place for her at the table sitting with a couple. The man of the couple has been awarded a prize for his work. She then began a familiar lament - he had everything, he was leaving her behind because she was so unsuccessful, such a failure.
The analyst had a striking response to this material - she felt drawn into “an intense identification” with the patient, recalling a personal experience of rejection from the past. The analyst's first intervention attempted to express her understanding of the patient's experience of rejection, viewing herself as inferior. The patient replied that what the analyst had said was exactly what she was thinking: it was “almost as if you were speaking my thoughts from inside my mind”.
The patient went on to emphasize that the analyst was “so on track”, “hit it just right”, “such a moment of connectedness”. She wished she was as smart as the analyst, she could not speak or write so perfectly, and she would never be as successful in her work as the analyst. The analyst tried to raise the question of how she could have understood the patient's feelings of rejection so well when she was being built up into someone who had everything.
The patient responded by once again emphasizing the analyst's academic success, but then added that men have something “we (women) don't have”. Even when they promote women it is because of affirmative action. She describes the analyst as “a sort of honorary man”, with her success.