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It is very difficult to write briefly about any analysis, and it is doubly so to deal with what is partly autobiographical. We are indebted to Dr. Little for a courageous effort. I regret the fact that I do not find him entirely convincing. I hasten to add, however, that he “was there” and I was not; and I can therefore only reflect what I know to be distant impressions.
It is not always clear, in reading the paper, how the term “survival value” applies. Although Dr. Little states clearly his belief that certain transference and countertransference happenings “saved the analysis,” some passages seem to point to the “survival value” of these events for the patient herself or for the analyst. The one does not preclude the others, of course, but the meaning in places could be made more explicit.
I am not convinced that the analysis was saved because of technical mistakes caused by countertransference. At the time of Dr. Little's coronary illness the analysis was just six months under way. He and the patient's mother went to the hospital on the very same day. When the analysis resumed it was appropriate, it seems to me, to deal with the patient's anger and fright as related to both events. If he “choked off” the patient's anger he may have been in error, but failure to relate the feelings to the deaths of the patient's father and uncle (when the patient was a child) was, in my opinion, no mistake. Dr. Little tells us that the patient's chief problem was with her mother, and it seems evident that the attachment to the mother was not entirely of the mother's doing.
I do not know what enabled the analysis to continue during the crisis described by Dr. Little, but I think it just as likely that he was correct rather than in error in dealing with the patient's feelings in terms of the “mother transference.” His wanting the patient to take care of him and thereby playing into her characterological defenses is something else again. Such variables only point up the inadvisability