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Denise’s case presentation is an eloquent and courageous description of a mutually evolving connectedness, with all the pleasures, satisfactions, life threatening fears, harrowing twists and turns inherent in the emergence of a life saving treatment. Not only does Denise capture the uniquely sadistic trauma that Will experienced and brought into the therapy, but she boldly and openly shares her own vulnerabilities as she travels with Will into dangerous and mutually uncharted waters on this healing journey.
Attempting to discuss a successful treatment where the therapist has provided both detailed clinical interactions and a cogent theoretical rationale for her interventions is always a difficult task. What more can I add to such an iconic treatment? In this case it is further complicated by the reality that Denise asked me to be the consultant for this precarious odyssey, and I chose to do so. I chose to do so not only because I believed that Will could be helped with a self psychological treatment, and that those who thought Will was too dangerous to take on therapeutically were wrong; but more importantly because Denise and I were close colleagues and friends; I knew her work, and I believed strongly in her capacity to treat Will. So in this instance the discussant and the consultant are one and the same. I thought what may be most helpful in this discussion is for me to offer, from my own self psychological perspective, 1) an understanding of what happened between Will and Denise that made this treatment work, and 2) how I conceptualized my role in this very difficult treatment when in fact I had such a strong belief in my good friend’s capacity to help Will.
In order to accomplish this multi-faceted task, I think it’s important for you to at least briefly understand my own beliefs about the elements that underlie a successful treatment. My definition of analysis (which includes psychoanalytic psychotherapy) is that the analytic process is an empathic encounter th