The Case of J: Returning to the Office

As a child, I remember my parents having read to me The Little Engine That Could,1(Piper 1930). Now, reading the same story to my grandchildren, I realise I had forgotten how in one sense it was tedious and repetitive but also contained wonderful drawings of trains, and animals, and circus performers. It was largely a story of how one needs lots of help. That trying to do things alone, though a part of growing up, can also be part of the arrogance of an omnipotent phantasy, both conscious and unconscious, that interferes with doing and accomplishing what at times feel like impossible tasks.

Working as an analyst during the last two years during the Covid pandemic has been, I believe, just that. Janet Malcolm (1982) wrote that our profession was an “impossible” one. She was both wrong and right. What truly makes it impossible is if you succumb to the arrogance of needing to do this endeavor alone. Without others such as colleagues, supervisors, friends and patients, we are forced to become analysts who must go it alone. The shielding over the last few years has left me, at least, finding the isolation within clinical work far more intense and troublesome than the known and desired analytic isolation of being with a patient lying on my couch in my consulting room.

Through the generosity of Dr Y, we are able to see her work with her patient J once again (Bronstein 2020). The Covid virus has taken a terrible toll on the physical and emotional well-being of many, and has caused psychoanalysts everywhere to shift the setting of their analysis; I see this as a move which was brought about by a kind of evolving terror and desperation on the part of both our patients and ourselves, as I mentioned in my first discussion of J. It was not a choice to work remotely, whether via telephone or zoom or another platform. It was forced upon us, not by distance but by a mutual fear.

The “Case of J” allows us to look at what has been the desired isolation, intimacy and privacy we used to h