The Genital Psychoanalyst*

Of all the dilemmas patients create for their parents and their analysts, those involving sex and anger are the most problematic. From its inception psychoanalysis has been rooted in the problems generated by mismanagement of these instincts, both by the patient and in the analyst. A parallel may be drawn between certain feelings generated in a mother's response to an infant's needs and the countertransference feelings aroused in a psychoanalyst in response to a patient's needs. Analysts, like parents, are faced with two mutually dependent tasks: how to deal with their patients' feelings and how to deal with their own. When parents cannot respond adequately to their own hostile and sexual drives, they cannot supply their children with a model of how to cope with such impulses. In order to provide patients with the psychic equivalent of adequate mothering during analysis, so that they are able to grow to maturity, analysts must have grown to maturity themselves. Analysts must be reasonably free of neurotic anxiety; that is to say, have reached the phase of psychosexual development that Karl Abraham and Wilhelm Reich referred to as the genital phase. For the genital analyst, treatment is a reciprocal relationship from which the analyst derives pleasure and satisfaction, while at the same time endeavoring to relieve the patient's suffering.