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There are books we review and there are books that make us review our own inner struggles. Meissner's book fits into the latter category. For over a year, I read and reread Time, Self, and Psychoanalysis, and each time I discovered new ideas to think about and use in my work as a psychoanalyst.
As I went through the book, I found myself thinking about some of my own patients whose most profound conflicts were expressed through distortions of the analytic framework, especially around matters of time. I was reminded in particular of my 29-year-old male patient, Dr. D, a psychiatry resident who started a five-times-per-week analysis, with his appointment times arranged only on a weekly basis in the early part of the analysis. This arrangement was initially rationalized by his being in a demanding training program. However, it soon became clear that his inability to have even a regular monthly schedule with me (unlike most other residents, who rely on their monthly call schedule to plan their analytic meetings one month at a time) had some very important meanings. Early attempts to understand this with Dr. D were met with great anxiety on his part and an insistence that this arrangement had to do only with external reality. Once his residency ended and we attempted to move toward regular appointment times, even greater anxiety emerged.
For my part, I realized that I had been accommodating and incorporating Dr. D into my analytic work schedule much in the manner that a mother might accommodate an infant or young child's needs and demands into her days and nights. I consciously questioned his rationalizations about why only a weekly schedule could be planned, but unconsciously, I kept going along with him.
A little over two years into the analysis, I could finally allow myself to feel the toll this was taking on me and could begin to experience a sense