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Dr. Ernest Angel's poignant, honest paper, “The Resolution of a Counter-transference through a Dream of the Analyst,” (Vol. 66, No. 1, Spring 1979), describes how “resolving” a countertransference issue helped him to “lose” a patient. The issue hinged around his defensive irritation with a young female patient, his rage and outrage. He was able to experience her more openly as he began to work through feelings toward a humiliating sister which he partly displaced on to the patient. It was when he was able to interpret more compassionately that the patient, frightened by vulnerability, left.
The vignette is a human story, humanly told. But, it seems to me, certain of its implications need spelling out. It appears that the patient stayed as long as she was “hated” by the therapist and as long as the therapist was made “up tight” by her. Dr. Angel seemed to feel that such feelings on his part were “wrong” or non-therapeutic. Or perhaps, more precisely, he was, in part, ill at ease because he was for a time unable to embrace such negative sources of information therapeutically. For a time he was unable to use such negative states well.
I formed the impression that Dr. Angel felt that only interventions made in a “good” spirit, the “good” analyst, could truly be helpful. He felt relieved when he recovered his therapeutic “cool” and so could respond more warmly. As he pointed out, such therapeutic “goodness” frightened the patient, made her the more guilty or paranoid, and forced her retreat. Yet he felt glad that he finally acted out of integrity, that he recovered his self-respect. However, in doing so he became for the patient too much of an alien other.
The implication is that the analyst could not maintain his self-respect and at the same time carry enough “therapeutic sadism” so as to be recognizable to the patient. The patient, it appears, became a temptation for the therapist to “prove” to himself (and to his sister?) how open he can be in the face of what once was a