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My reading of P's treatment narrative uses Lacan's distinctions among three dimensions of experience that he calls the Real, the Imaginary, and the Symbolic, dimensions that help to conceptualize the patient's “need” and to differentiate it from her demand and desire. These are salient issues in the case material insofar as Dr. F repeatedly uses the idea of “need” in his own reflections on the analytic process, and insofar as that process, as presented, operates for the most part in Lacan's dimension of the Imaginary. In so reflecting on the meaning of the analytic process, we are acknowledging that in the analytic moment itself we are likely to be governed by factors beyond conscious consideration, and that these factors have escaped both the analyst's and our retrospective efforts. This well-known caveat lies at the heart of Felman's (1987) brilliant rereading of Freud and Lacan.
Dr. F appears to respond to perceived “needs” in his patient by attempting to establish and reinforce a type of one-to-one reciprocal relationship in which mirroring and idealizations are prominent. From Lacan's perspective (1988) this amounts to a “two-body psychology” that excludes the mediating role of the unconscious and of the symbolic register as a third, as Other, to the dual, ego-to-ego-relationship. Without the explicit positioning