Mistakes

Psychoanalysts frequently make mistakes, but these errors often go unacknowledged because of the analyst's sense of shame. This is regrettable because mistakes are widely recognized to contain new and very useful clinical information. In three clinical vignettes the author describes the kinds of clinical errors he has made: errors associated with a defensively false analytic self, mistakes based on his narcissistic investment in the patient, and errors made in transference/countertransference enactments. These clinical vignettes demonstrate a method of repairing mistakes that involves disclosure, the selective communication of countertransference, and apology. A visual metaphor is used to describe the process of mistake and reparation: The analyst's “mis-take” is a failure to “see” an aspect of the patient's subjectivity. After expressing distress at feeling “unseen,” the patient helps refocus the analyst's vision. Through this mutual process of refocusing a therapeutic symbiosis develops that causes the patient to relax his or her defenses and thereby bring into vision previously unconscious aspects of him or herself, creating an expanded sense of self. Paradoxically what began as a mistake becomes therapeutic through its reparation.