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There are a number of issues which make this a tempting paper to discuss. First, it is fascinating clinically, describing as it does the appearance of a character structure—a clinical state—we had not recognized before. Second, it gives us clues about etiology, describing, more precisely than is usual in the literature, the mother's role in creating a given condition. Third, by means of clinical findings gathered especially from the perspective of the transference reaction, it examines aspects of metapsychology in a deceptively simple way that I nonetheless find more significant than the endless bowel-churning into which metapsychologizing can deteriorate. However, one must use restraint, and so I shall focus only upon two other issues.
The first is that this is a radical paper on technique. Khan is willing to tell us that he does something with his patients that is officially disapproved: “an aggressive encounter and experience in the analytic situation, through which they will be able to experience the validity of their own aggression and hate as well as that of the non-self person (the analyst) … The analyst's capacity to provide a positive, aggressively intent presence … will provide the patients with experiences of objective aggression, hate, separateness and concentration … [in] the right dosage.”