Epilogue

Connectedness between analyst and patient is an unpredictable, emergent process. How might the analyst nurture an experience of emotional connection while also respecting the patient’s sense of agency in how she might need to regulate that experience? In the foregoing articles, Steven Stern describes how a sense of connectedness was struggled with, how it emerged, and how it was transformed between him and his patient Linda. Discussants David Wallin and Donna M. Orange offer alternate views of the challenges that Stern and Linda faced, suggesting different clinical paths. This epilogue compares and contrasts their formulations.

First, how might we understand the trajectory of Stern and Linda’s relationship? In particular, how might we understand Stern’s formulation that his patient was “connection-resistant?” Did she resist connection, or was she trying to ward off the sense of weakness and vulnerability that she expected would accompany it? In his reply, Stern formulates that Linda sought not only a sense of connectedness, but also a sense of personal power. That she stayed nine years with Stern and nine with the analyst before him suggests that she is good at connection, but perhaps not the intensity or consistency of connectedness that Stern assessed she needed and that he wanted to provide. What in their relationship might have made it difficult for him to feel connected to her?

On the first day of treatment, Linda said, “I want someone who can hold my feet to the fire. I can be controlling and slippery” (Stern, this issue, p. 180). This metaphoric statement captures much of the complexity and challenge inherent in this case. It conveys Linda’s experience in sustaining connection through being controlling and slippery while also conveying her desire to give up this controlling-slippery strategy. Her statement reflects the confidence she already has in her new therapist, that he might engage in