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Introduction by Elizabeth Dorsey
I remember the day this paper was presented. It was unseasonably hot at Clark University in Worcester, MA, site of the historic U. S. lecture series by Freud and Jung. A standing-room-only crowd packed the auditorium to hear Gerald Adler, Peter Giovacchini, Phyllis Meadow and Harold Searles. The conference, On Becoming the Patient: Countertransference Issues in the Treatment of Borderline and Narcissistic Personality Disorders, was sponsored by the Boston Graduate School of Psychoanalysis. I return to this paper when I am excitedly preparing a presentation or class, but equally when I am discouraged about a particular treatment or supervision. Meadow's restatement of the basic assumptions of modern psychoanalysis, that destructive impulsivity is dominant in a preverbal character and that the analyst regresses in the induction with such a person, gives me heart to stay the course in the challenging businesses of analyzing, supervising and teaching.
Meadow's premise is that the analyst must aim to be willing and able to go wherever the patient takes her. She stresses the importance of feeling what the patient is feeling, in order to understand what is being repeated in the transference. With the psychotic or narcissistic patient, the depth of impulses and fantasies predates containment with language. This message is a comfort to me when I am experiencing unfamiliar and powerful states in a