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Once again we have a most revealing paper from Dr. Searles and his co-workers. The revelation is not only in understanding the schizophrenic patient, but also in recognition of the deep inner impulses and feelings stirred up in the therapist. Dr. Searles, through his years of writing, has repeatedly described his own inner turmoil and eventual growth from the “symbiotic relatedness” that he allows the patient to achieve with him.
I believe that it is extremely difficult for most psychoanalysts to allow their feelings to be expressed in the therapeutic relationship on the level that Dr. Searles suggests is natural for him. Most analysts would find it very difficult to bring these feelings into consciousness and to consider them as valid material for the therapeutic relationship; they would tend to regard them as countertransference phenomena best handled in self-analysis, or perhaps in a supervisory situation. There are usually some transient emotional phenomena occurring in the analyst that serve as important clues to his understanding of the patient, but to incorporate these feelings directly into the therapeutic process would be very unusual.
How does the patient experience the development and expression of such strong feelings on the part of the therapist? Dr. Searles and his co-workers point out that this can be an extremely therapeutic experience for the patient, since the resulting symbiotic relatedness provides a means by which the patient can re-experience his inner psychic turmoil of the past for the later development of a more mature and integrated ego. In other papers Dr. Searles has talked about the development
of symbiosis from the ambivalent to the pre-ambivalent that he believes is necessary in the therapy of schizophrenic patients. In our paper “Projective Identification in the Therapeutic Process” (1966), Dr. Grotstein and I suggested that it is the way in which a therapist responds to the patient's projections that allows modification of these proj