Case Response I

The work with Patricia reminds us of the limits of ego-supportive psychotherapy and what we usually think of as empathy. When what we think is empathic mirroring of the individual's emotions, we are rudely informed of just how mistaken we really are—Patricia's, “Don't ever do that again!”, in reply to what the analyst thought was a compassionate response. True empathy is not a simple mirroring of the affects we think/sense the individual is expressing, it is attempting to put into words and actions what is trying deeply to be said, but cannot. And of course, the therapist needing to survive it all in the meantime.

My clinical approach (Cwik, 2011, 2017) involves orienting towards what I call the “alchemical third.” In Jung's now well-known diagram of all the possible conscious and unconscious connections of the analyst with the analysand, the alchemical third is that unconscious to unconscious connection influenced by the archetypal pattern enfolding the analytic couple. We do not know what belongs to whom or who started what, leading to the mutuality affecting both participants. This becomes the object of the analysis, while reverie and what I call “associative dreaming,” are the means to decipher the nature of this unconscious interaction. Patricia and her analyst are in what I would call a subjugating form of their third: they are trapped in a larger

sadomasochistic configuration of the archetype. These patterns can bind the analytic couple for long periods of time: 20+ years! Patricia's inner world also takes a similar form.

Patricia's history demonstrates what Khan (1963) called “cumulative trauma.” There is a fundamental lack of any kind of early facilitating environment—not being wanted or adequately attended to, abandonment (loss) of father, and being a latch-key kid—so that she never developed a protective shield against overwhelming affect. As Khan (1963, p. 290) states, “My argument is that cumulative trauma is the result of the breaches in the mother's