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There seems to be increasing concensus that selective intentional disclosure by an analyst of his or her personal thoughts and feelings can be a useful feature of clinical technique and that we need to develop ways of thinking systematically about when and how such disclosure is best made (Cooper, 1998; Rosenbloom, 1998). Particularly problematic is the matter of an analyst's sexual and loving feelings toward his or her patient. It has been argued that such self-disclosure can be helpful (Davies, 1994), but the dangers of the analyst's disclosure of sexual and loving feelings and the problem of the slippery slope are well known (Gabbard, 1995). Under what circumstances and in what way are these fundamental feelings most usefully expressed in a well-conducted analysis (Davies, 1994; Gabbard, 1995; Slavin, 1998)? With these considerations in mind, I would like to offer the following vignette.
George is a thirty-five-year-old obstetrician in analysis for severe depression. Although he is married and the father of three, he feels he has no satisfying relationship in his life. Over the past two years, we have explored the ways that his religious upbringing resulted in a judgmental and moralistic overlay to his sexual feelings and fantasies, about which he is riddled with shame. Neglect by his distracted, concrete, intermittently seductive mother and ridicule from his successful businessman father were experienced in an emotional vacuum, as a result of which George developed profound self-loathing.