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Steve (to whom I will refer hereafter, in accordance with journal convention, as Stern) has offered us a compelling and poignant narrative of his work over forty years with a “psychically homeless” woman, Elizabeth. In so doing, Stern suggests a conceptual framework, three principles that capture for him key elements of what he terms “analytic adoption.” Stern is mindful of the complexities, paradoxes, and risks of clinically living out his principles of adoption. And he further notes, from a more metaconceptual stance, that the “model” he describes cannot apply as a Procrustean standard but always will be negotiated according to the specificity of two people engaged in the process of promoting the healing, growth, and freedom of a profoundly wounded patient. Clearly, Stern is commending to us the essential clinical function of being all in a primal mutual relatedness within the analytic frame.
We might pause here to ask whether Stern is describing a “parameter” specific to working with the “psychically homeless” or whether, tacitly, in the spirit of D. W. Winnicott or Paul Russell, he is capturing an elemental truth that applies in some form to analytic process in all good treatments. What we would have here, then, is an extreme instance of a universal.
Stern, invoking the work of Winnicott, proposes three principles for the kind of involvement required in treating the “psychically homeless patient.” First among his key principles is a variant of Atwood’s “radical engagement,” or “analytic love.” Stern acknowledges the contributions of Donna Orange (“emotional availability”), Elizabeth Corpt (“clinical generosity”), and my own concept of the analyst’s “generous involvement” (Pizer, 2014), but he is unsatisfied with these stances as an adequate response to “psychologically homeless patients.” He asserts, “They need us to be empathic, emotionally generous responders, to be sure, but more than that they also need us to be active agents who come to feel a personal invest