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All people, even analysts, retreat to more primitive defenses when threatened. These defenses include dogmatism and brittle certitude. When we read the works of the pioneers of our profession, we may be startled and refreshed, finding in their works not only a fluid creativity, but additionally, explanations for the evolution of apparent differences within our profession. We often find our patients focusing on immediate difficulties, whereas we simultaneously are preoccupied and beleaguered by our own present uncertainties. We can find new insights in the study of our professional roots, just as we strive to help our patients become aware of the life-long evolution of their distresses.
In this age of medication, in which our work with patients is muted, far less dramatic and intense than it was in earlier years, it becomes vital that we study the works of the master clinicians and subject our current work to their scrutiny. Our active intervention of prescribing medication should, I believe, be built on a firm grounding in psychotherapeutic technique and a knowledge of its historical evolution. However, no amount of reading can substitute for the experience of intensive patienthood, as Fromm-Reichmann (1950) and others have stressed. Especially now, in the current situation in which external financial and governmental forces may leave us feeling helpless or victimized, with bitter pills of our own to swallow, we need to acknowledge our metaphoric patienthood. We must stay alert to our counteridentifications with our patients, aiming at understanding our personal and professional pasts, with their range of regressive and more mature defenses against anxiety.
When the subject is countertransference in the treatment of