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Little attention has been given to the emotional price paid by psycho-analytically-oriented therapists in the pursuit of remediating the suffering of their patients. Abstinence, delay, and inhibition of even indirect instinctual gratification at the expense of the patient have all been accepted as necessary requirements of the analytic frame. While as helping professionals we are rightly concerned with the potential for exploitation and victimization of those individuals who come to us with pain (Menaker, 1942), it can not be ignored that a heavy toll is imposed upon the therapist, especially in the treatment of severely disturbed individuals.
The motives, talents, and skills which converge to bring someone to such a profession are complex and varied. Yet, it is relatively common among therapists to find underlying the wish to cure the patient a deep and abiding wish not only to cure oneself but also to heal the suffering of one's parents. As such, the motivation of the therapist mirrors one of the hidden dynamics in the patient's life. Nowhere is this equivalency more noticeable and noteworthy than in the treatment of those severely disturbed individuals who seem to cling tenaciously and masochistically to the very “bad object” which has been the source of their suffering in the past. For this reason, treatment of this type of patient places special demands on the therapist to observe, manage, and resolve his or her countertransference.
The following clinical material briefly illustrates how the therapist's therapeutic aim can become intertwined with the patient's masochism. It will be suggested that the patient's recovery is facilitated by the therapist's ability to present himself or herself as alive, active, and