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We feel that it is deeply important to respond to these letters.
The intent of our paper is to clinically demonstrate a theory of permeable boundaries, which also includes our belief that the transparency of clinical data is useful for deepening the understanding of what can happen in some treatments. As we reflect on our process, it makes Meredith think back to the case of Mr. Z, which was one of the original inspirations to write the paper. Meredith was curious about his need to simultaneously expose and conceal his treatment. In developing a theory of the self, Kohut knew as both psychoanalyst and patient, we were our greatest asset, and it is best we make use of this. Kohut was in a place in history where he knew among his classically thinking colleagues that sharing this level of transparency and vulnerability would be misunderstood and rejected. In writing this paper, we believed transparency and vulnerability would be welcomed in our self-psychological community. To a small, yet loud group of people, we were very wrong in assuming this.
We are aware that to some people this is a controversial paper, but to others it has felt like a welcome invitation to talk about something that is being practiced but rarely straight forwardly talked about. In reflecting back, we have conflicting feelings about how people were distracted by our relationship. While there is nothing we can do about the nature of our relationship, we feel disappointed that this became one of the main focal points and perhaps took away from people seeing the efficacy and significance of permeable boundary theory. We feel it is important to say that this is not prescriptive, but rather a frame that should only be practiced if there is a transcendent1 quality in both therapist and patient. Permeability is grounded in self psychological theory because of one of Kohut’s most important concepts, which is the idea that the patient experiences the therapist (or her functions) as a part of one’s own self a