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November 10, 1990. THE ANALYST'S RETREAT FROM THE PATIENT'S VANTAGE POINT. Evelyne Albrecht Schwaber, M.D.
Dr. Schwaber discussed the countertransference implications involved in the imposition of the analyst's sense of reality upon the patient. She referred to a general tendency for analysts to move away from the stance of listening and inquiry, and she offered reasons for this in terms of countertransference reactions. Although there are divergent points of view about countertransference in the literature, Dr. Schwaber concluded that "there is little dispute that the countertransference must, at the least, be located by the analyst in order to further the clinical endeavor." She cited previous works in this area that delineate modes of listening in which the patient's "vantage point" is less obscured by the analyst's preconceptions about reality. She emphasized "affective shifts" in the clinical material which may enhance the patient's self-observing capacities and reveal ways the analyst is being perceived. This activity informs the analyst in an ongoing manner about attitudes which run counter to inquiry into the patient's sense of reality and self. Dr. Schwaber presented several clinical vignettes illustrating self-analysis of countertransference, which allowed her to resume listening to what the patient was saying without unconsciously distancing herself because of conflicting notions about reality.
Discussion focused on the vignette of Mr. K, who entered analysis because of feelings of loneliness. He was intelligent and college educated, but dyslexia had made the experience of education painful and humiliating. Mr. K hoped to return to school eventually. Through associations, he became aware of the connections between his learning problem and conflicts about sexual identity. In response to his talking about returning to school, Dr. Schwaber suggested that perhaps engagement in formal learning might shed light on his sexual difficulties; Mr. K seemed