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Presenter, Renee Welner, M.D.
Present: Drs. Rittenberg and Wyman, Medical Directors; Drs. Baudry, Birger, DiGangi, Goldsmith, Glass, Lieberman, Link, McNutt, Perri, Porder, Sherkow, Wein, Welner, Willick.
Dr. Willick asked if anyone had asked the patient why she had thought her jealousy of her husband was irrational. Dr. Welner had asked, and the patient revealed that she felt guilty about her anger toward her husband. Dr. Willick felt that she wanted to be loved by her mother-in-law and this may also have motivated her to deny her husband's infidelity. He asked what about the patient had raised early concerns about analyzability?
Dr. Welner answered that the patient's canceling of sessions when angry, and more importantly, her initial inability to give a coherent narrative raised concerns. Dr. Willick asked about how the analyst and supervisor took up their disagreements. Dr. Welner said that they had many disagreements which crystallized over the issue of the fee. The supervisor had had serious reservations about the patient's analyzability from the beginning. He also felt that she would never be able to make a decent living.
Dr. Willick commented that it is difficult for a student analyst to disagree with a supervisor. It is hard to analyze a patient when the supervisor considers the patient to be unanalyzable. He feels that the analyst's confidence in the patient was helpful to her, enabling her to tolerate her anger at the analyst. He added that initial assessment is always difficult and commented that he no longer thinks in terms of preoedipal versus oedipal psychopathology. He usually finds a mixture of such phenomena in all patients.
Dr. Rittenberg wondered about the importance of the supervisor's optimism, and Dr. Willick said that all supervisors have a “counter-transference” (very loosely defined).
Dr. Wyman asked if Dr. Welner experienced the first supervisor's “countertransference” to the patient or to herself. Dr. Welner initially felt his pessimism towar