Life Used To Be So Easy: Commentary on Papers by Gruenthal and Hirsch

If I had known at the beginning that my role as an analyst would become so complicated, I probably would never have started. Now, not only do my theoretical constructs help to shape my patients' experience of me (Gruenthal), but my stage of life and family formation profoundly influence the way I experience and respond to my patients (Hirsch). My theory and my age are thus part of the problem my patients and I face together. Before long, I fear, I will be told that my very character structure, “the organization of my self,” is the most significant element in the treatment relationship, even more important than my theory and technique. Where will it end? Have I no privacy as an analyst, no power base of abiding knowledge from which to operate as a source of interpretive wisdom?

As a physician I came out of a rigorous positivist tradition. In my orthopedic surgical residency, X-rays and physical examinations told us all we needed to know about the patient beyond the presenting complaint. I was torn from this comfortable professional life by two compelling events which converged on me at an impressionable age. They both impinged on my omnipotence and grandiosity from opposite directions, forcing me, like a sailboat between wind and water, onto a new course. The first was the agonizing death of a young man under my care following a motorcycle accident in which all the bones in his limbs were fractured and irreversibly infected. I had not realized that the attending surgeons chose not to see him during their rounds because they knew that it was hopeless. They left it to the most junior house officer, me, to handle. The young man died horribly, and I was deeply affected by the