Discussion of A Candidate at Work: The Case of Ms. N.

I congratulate this candidate-analyst for demonstrating his work so that we might learn from it. The ability to show one’s work and to ask for help, especially with difficult patients, is of primary importance in our work as analysts. In treating patients like Ms. N., who is, by history, multiply traumatized, and who has an intense erotic transference, it is particularly crucial to open one’s work to other analysts’ thoughts, experience, and associations.

I must acknowledge that it can be difficult to discern what informs an analyst’s work from a report of only four sessions, the last two following a two-year period of treatment and occurring shortly before termination. Nonetheless, I was struck in these sessions by this analyst’s removing himself from his patient, which he describes as coming from discomfort with her curiosity about his life and her “stalking” him. This, he writes, made him “feel that I had to adopt an attitude as protective shield and neutral as possible.” Indeed, the patient’s emotionality, her confusion between her “stories” and reality, her fragile object relations, and her determined erotic transference would make this a particularly difficult case for a candidate to analyze. From the sessions, it does seem that this candidate-analyst works from a determinedly neutral stance, within a technique of analyzing in the “here-and-now” by making frequent observations aimed primarily at the transference. Despite his focus on what is happening immediately within the session, however, this analyst’s attempts at neutrality make it seem that he comes to the treatment from a distance, rendering him sometimes out of touch with his analysand’s experience. For example, during Session One, which follows the patient’s having seen the analyst outside the office with a woman, she remains silent for five minutes, crying, and then describes getting into bed with her father during childhood, lying on her side with her chest against his back, wishing he would turn to