Discussion Following Dr. Robbins' Address

Question: Dr. Robbins, how did you share that image with the patient?

Dr. Robbins: I described my experience word for word as I just stated it to you. I think every patient needs a different kind of interpretive intervention. For some patients sharing an image becomes a form of intrusion—it is experienced as an invasion. With others it is experienced as a form of empathy. When and how we share and our style of sharing depend on the nuances and sensibilities of that relationship. And certainly not in all relationships would I be so frontal and open in sharing images. In this patient it aided and facilitated a sense of equality which was so important for her to strive towards. The problem in the transference/countertransference relationship is that we have a patient who is hungry and needy for contact and yet as we give contact it is often experienced as a form of patronizing. So that how I could offer contact with her that was respectful seemed to be organized in this sharing of the image.

Question: I feel your feelings about risk taking and I like the idea of taking a risk. I wonder whether you would call it a parameter rather than an interpretation, in terms of giving what you saw in terms of visual image rather than an unconscious interpretation.

Dr. Robbins: My use of the term interpretation is fairly broad. I don't see interpretation limited to making the unconscious conscious, in the more classical form, although at times I work very classically with patients who fit that mode. The notion of parameter is one of taking a deviation from the classical position of maintaining a neutral stance and offering what you are seeing in the relationship in a direct fashion. Each patient requires a different interpretive style, and there are many ways to get insight to our patients. Sometimes by sharing what is going on inside of us, insight from past to present occurs so that the notion of parameter is not part of my language. I know it is part of the language of a more classi