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I began collecting data on my method of doing a consultation about fifteen years ago. I undertook this project in response to my awareness that many well-trained colleagues, young and old, were having trouble developing satisfying analytic practices. Because my experience was so different I conjectured that there might be something subtly different in my style of working that was worth attempting to understand. That project led to a series of papers and culminated in my book Psychoanalytic Technique and the Creation of Analytic Patients.1
In the process of subsequently discussing and elaborating my ideas I have become explicitly aware that I work from an intersubjective perspective. The evaluative model that I criticize derives from, among other things, the mythic idea that objective assessment of another human being is possible.
Before responding to the six discussants, I will briefly outline a trusting model that may be helpful to an analyst experiencing a person who seeks help. The model emphasizes the analyst's communicated attitude and has six points:
Analysis is the optimal therapy for most patients who seek analysts' help;
Recommend a trial of analysis;
Begin the analysis in any way the patient is able to begin. The ultimate goal is to help the patient experience the optimal parameters associated with an analytic experience: the use of the couch at a frequency of 4 or 5 times per week.
Think of the patient's reluctances as enactment resistances. From my inevitably biased analytic vantage point, these are best understood as compromise formations;
Consider the possibility that the urge to diagnose a patient may reflect a countertransference enactment;