Response to Dr Ricardo Bernardi

Dr Bernardi has brought to the attention of readers some of the differences between his view of change in the case of K and those of Dr Feldman. These differences reflect a number of factors which he discusses in terms of the evaluation of change within a psychoanalysis.

The issues raised go well beyond the scope of a letter to the editors and beyond what I, as editor of the Analyst at Work section, can discuss adequately and thoroughly in a short response. I do agree that these are seminal questions and need much fuller discussion and thought and I thank him for raising them both in his letter and his response to the clinical material of Mr K.

One issue that can be addressed here is that of the evidence Dr Bernardi discusses that would result from the analyst's discussion of his own countertransference responses. Although many clinicians find this a valuable way to measure and assess a degree of change in clinical work, both I and the Analyst at Work panel believe, at least for the purpose of this section, that countertransference is a complicated question which can often show a misleading series of data points. We therefore generally ask contributors to only bring in their countertransference reactions when they are very obvious, elicit clear enactments or have become a central part of the analysis as evidenced in the sessions presented. We of course respect the value and importance of countertransference as an indicator of how the analysis and analyst work, but we have found that the analyst's own descriptions of their countertransference vary by clinician, theory and experience and have decided therefore to allow the clinical hours to be more or less free of such added comments. The experience of the readers and discussants then is open to judging the clinical material as it appears in a series of sessions. It is for these reasons that the evidence that Dr Bernardi would have liked included was omitted at the request of the editors.

Dr Bernardi's contention that he