Chapter 8 The Shame Experiences Of the Analyst

In a recently published paper, Fonagy and Target (1995) tell us of a patient with a congenital deformity of the spine, who, unkempt, unshaven, and dirty, declined with contempt any help from the analyst, while at the same time asking for it, and sneeringly rejected an interpretation involving his dependency on the latter. This patient started an analytic session by suddenly taking off his shirt to reveal his deformed back, leaving it exposed for the entire session. “I felt revulsion, confusion, and then shame,” writes Fonagy (p. 489). His comments about the patient's attempt to preempt his anxiety of rejection “by trying to control the feelings of those around him” (p. 489) met with derision, although Fonagy sensed that his interpretation had been true; the patient, however, refused to accept the analyst's empathy with “the sense of injustice and hurt which seemed to drive his bitter hatred.” But then Fonagy (1995) had the idea of telling him: “It seems that you feel safer when someone is uncomfortable” (p. 489). “To this the patient readily agreed,” writes Fonagy (1995, p. 489).

This is one of the few mentions in the literature of a shame experience of the analyst, which is, however, not further discussed. I think that precisely at the moment that Fonagy sensed more directly the patient's