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I am pleased to have Mr. Waska's rebuttal to my critique of his earlier paper. I am particularly glad to note the extent to which he has profited from his psychoanalytic education during the years since he prepared that paper; I doubt that he would write it in the same way today. Still, my original comments were directed to the text as published, rather than to his current views as enriched by the valuable training experience he has had in the interim.
I don't think it would be useful for me to respond point by point. Let me select a few items that may help to clarify both areas of agreement and of disagreement between us. Despite Mr. Waska's conviction to the contrary, I continue to consider a once weekly, four-month duration, self-terminated treatment (shades of Dora!) an inadequate testing ground for psychoanalytic theory or technique. Indeed, Mr. Waska acknowledges, as he did not in the paper, that there were “many missed appointments” and that he “pursued her with phone calls.” I would (and I believe he would too) regard this as a blatant transference-countertransference enactment that would certainly have skewed, if it did not preclude, significant analytic work, even in a standard analysis.
Mr. Waska seems to have misread my observation about his conceptual framework. I said (p. 479) that his “whole approach is founded on a generic reconstruction”—not a “genetic” one. He is, of course, correct in stating that all psychoanalytic theories are founded on genetic assumptions. The issue here, however, is that, to my reading, he was operating on the universalist notion, shared by many in the object-relations school(s), that all psychopathology, and certainly all narcissistic pathology, derives from maternal deprivation and/or empathic failure, and the consequent lack of “internal self-soothers.”