Discussion of Charles William Wahl's Article, Psychoanalysis of the Rich, the Famous, and the Influential

Dr. Wahl reminds us once again of a ubiquitous clinical pitfall, at least to some extent derived from the dehumanizing aspects of our medical educations: the tendency to identify another human being by some single aspect of his current status. Such references as “the tubercular on Ward A,” “the bleeding ulcer in the E.R.,” or “the post-partum psychosis upstairs” are familiar to all of us. The persistence of such a tendency in a psychoanalyst is indeed sufficient ground for attempting to investigate its meaning and derivations, for if an analyst is captivated by a particular aspect of a patient, be it wealth, fame, influence, or any other of the endless array of

characteristics which go to make up an individual, I think it is safe to prognosticate that the analysis is in for some difficulty.

I am somewhat troubled by the designation of rich, famous, and influential patients as “categories,” and I am skeptical—though admittedly not in possession of adequate data—“that many more patients in these three categories” have “incomplete, ineffective, or unsatisfactory analytic experiences than any other category of patient.” I would not expect any correlation between such phenomena as affluence, celebrity, or degree of influence and the standard nosological entities. If these three attributes have a special potential for leading to complications in analysis for the reasons Dr. Wahl suggests or for any others, my own experience does not bear this out. Since such designations as wealth, fame, and influence have no agreed-upon boundaries, I do not know how many of my own patients, past and present, qualify; but after more than 20 years of psychoanalytic practice, I assume that some of them do. Even if we grant that “such patients” often fail to “receive” a good therapeutic result, one must not ignore other factors which contribute to the failure. The more “special” a patient is to the analyst for any reason, the greater the potential for countertransference difficulties.

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