Is the Analytic Situation Shame-Producing?

A great number of patients complain about the fact that the analytic relationship is not mutual. They point out that they know nothing about the therapist's private life, while they are supposed to reveal all intimate details of their own. It may be a humiliating experience to discover that the analyst has become such an important part of their lives, while they feel - rightly or wrongly - as if they are just one of many clients in the analyst's pool. They may doubt the authenticity of whatever attention, prizing, encouragement, and empathy they receive, regarding it as only ‘professional’ behaviour. A huge factor in the agony of patients who have fallen into intense transference-love is due to the shame and humiliation it causes them. We have to consider that this suffering may be a very human and ‘natural’ reaction.

One has to admit that, from the point of view of the patient, the analytic situation is in fact rather ‘weird’. Patients are supposed to trust a complete stranger with their most intimate and perhaps embarrassing concerns. This stranger may claim to be a specialist in matters of the psyche, but otherwise one has no particular reason to trust him or her. Thus, it is the most natural thing in the world when patients begin to falter in their trust of the analyst. With good reason, anxiety is aroused by the prospect of feeling vulnerable, small, and ashamed as soon as they lay themselves open, giving the therapist every opportunity to hurt, reject, criticize, belittle, and even to take advantage of their weakness. Should shame-anxiety always be attributed to the patient's transference feelings? May it not also be caused by the reality of the analytic situation itself? This is the question that I will pursue in this paper.