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Our topic is how our theories shape our psychoanalytic technique, and Dr. Fosshage is to be thanked for presenting clinical material that allows for such an exercise. I will initially be more specific about our points of divergence, although we have points of convergence as well; the purpose of this exercise is, after all, to focus on what distinguishes one set of theories from another, and how these differences affect technique.
We seem most to differ in the general area of to what extent the analyst is what has been called a “real new object” and to what extent he or she is a transference object. Implicit in this contrasting point of view is another; namely, is Dr. Fosshage's patient best understood as suffering from a deficiency or a conflict disorder. The theories that support the clinical concept of deficiency disorder go hand in hand with placing an emphasis on the analyst as a real new object whose empathic attunement compensates for the previous empathic failures of the primary objects. By contrast, another set of internally consistent concepts would hold that the empathic failures of the primary objects create ego structural malformations, conflicts, and compromise formations; that these are later played out in life as well as in the various narcissistic transferences in which the initial insult with its resultant means of responding are reenacted. In such unconscious scenarios the