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It is a special pleasure to discuss this valuable and courageous contribution of my friend and colleague, Peter Thomson. The paper calls attention to a relatively neglected area the analyst encounters when, guided by the principles of intersubjectivity, he or she attempts to analyze the central clinical phenomena and the states of mind of more difficult patients. It is basic to Dr. Thomson's approach that the difficulties encountered in the treatment of such patients can only be comprehended as occurring within a field in which the impact of the analyst on the patient's experience makes a continuing and codetermining contribution to the evolving events. I stress codetermination because one of the very great contributions of the intersubjective perspective is that it provides a clarifying focus with which to delineate the roles of each of the participants to the unfolding interaction. This in turn helps to understand better the nature of psychoanalytic transformations and what is required to bring these transformations about. The emphasis placed by self psychologists (including myself) upon the contribution of the analyst, when he is experienced as failing in a selfobject transference, to derailments and impasses in the therapeutic process sometimes has been misunderstood so as to minimize or obscure the contribution of the patient to the dialogue (Adler, 1989; Hitchcock, 1989). I believe that, where such misunderstanding occurs, unwarranted clinical compromise and collusion with archaic defenses can result, a point to which I shall return later in my discussion.
Thomson's interest in exploring the impact of his patients, Henry and Diane, upon his own self organization led him to prolonged reflection on the alterations in his states of mind. In order to do this,