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Paolo’s deeply stirring and evocative clinical material provides an impressive example of an extremely sensitive, unquestionably challenging, and transformative therapeutic process conducted at a particularly difficult time. It is a poignant description of the way in which therapist and patient managed to co-create an intersubjective space in which the patient was able to experience what Kohut (1984) posthumously described as the most fundamental experience for the development of a cohesive self—a feeling of “being human among other human beings”. The significance of this is amplified by the fact that this occurred at a time when Paolo’s patient, Marica, was feeling increasingly less human and more alien—akin perhaps to Kafka’s cockroach.
Paolo’s process material provides a valuable illustration of both the exquisite use and function of empathy—in this case to provide a timely and crucial twinship/alter-ego selfobject experience. I believe Marica’s experience with Paolo enabled her to find a way back into a relational world with an expanded capacity to feel and, particularly to “be” empathically human among other empathic human beings. I would hope that this might include the possibility of establishing a stable romantic relationship with someone if that ever were to become a “big deal” for her.
How Paolo managed this, given Marica’s early relational trauma, the alienating and traumatic surgical experiences required to save her physical life, and the sudden traumatic arrival of Covid-19 impressed me. There is something uncanny and synchronistic about the way in which Covid-19 arrived at the time that Paolo and Marica were working together. The way in which Paolo managed to co-create what I understand as an I-Thou relation with Marica speaks powerfully to many of the ideas that have been preoccupying me theoretically for a while now. In what follows I will share my thoughts about Paolo’s work with reference to a particular conceptualisation of the treatment of existent