Commentary on Paper by Stuart A. Pizer

In our response to Pizer's paper, we underscore the importance of discerning when to more deeply and conjointly explore emergent intersubjective moments in the therapeutic exchange. Pizer states that he would not now proceed clinically in the same way that he conducted his first treatment of his patient Rebecca, which occurred prior to his receiving full analytic training. However, he questions whether the therapeutic engagement would have advanced as well as it did if he had not offered various sponsoring and sheltering provisions to his patient. We believe that a more reflective and self-aware Pizer could have both supplied the provisions that Rebecca so desperately needed and more actively explored the meanings of their experiences together. Further discussion is needed regarding how impasses result when deepening analytic reflection and interpretation are not used to negotiate the multiple and paradoxical relationships that develop in treatment. In addition to training and consultation, we need to identify and utilize various ways to better understand what interferes with our capacity to negotiate the balance between remaining true to our own subjectivity and being enough of what our patients need us to be.