Author's Discussion

I begin by thanking the symposium chair and the symposium members for discussing my book. This was one of the aims I had in writing it, and I am deeply grateful to the participants whose careful, systematic, and scholarly reading of the book contributed so much to the discussion. The analysis took place between 1963 and 1965. I had completed my analytic training in 1961. I had not yet published an analytic paper and was relatively unknown when I moved to St. Louis in 1963 and became chairman of the clinic committee. At that time in St. Louis, we had an affiliation with the Chicago Institute as a geographic extension. All clinic cases had to be presented to the Chicago Clinic Committee for approval, and that is where this case was eventually turned down. I still thought it was a good case, and the husband's willingness to work two jobs to support the patient's analysis, the availability of a loan from his parents, and other financial arrangements made possible what previously would have been a major sacrifice.

In 1963, my practice was to take extensive process notes on each patient that I saw. My feeling, at that time, was that our field was deeply limited by our lack of primary data and we needed to begin to collect data. I have file cabinets full of notebooks of data, most of which, unfortunately, are unusable or unused because the material is either too voluminous, too vague, or too undramatic in its presentation. The idea of presenting this patient in book form occurred to me about two thirds of the way through the analysis. I became aware that there had been some rather rapid and profound changes taking place, and I felt that it might be possible as an analogy to the process of phase cinematography to show the evolving process in a more dramatic form. In that sense, this patient's case seemed to me to be ideal.

On the other hand, in order not to do anything to destroy this potential, I did not review the material as I received it. I did not begin to write the book