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Commentary and Response

Response to Howard Bacal’s Commentary on My Article, “Beyond Kohut, From Empathy to Affection”

, M.D.
 

Abstract

Dr. Bacal states that my article contained “a critical misconception of optimal responsiveness.” However, I was addressing a different aspect of therapeutic process, namely, the affective import of the moment when Kohut put his arm around his shoulder. Dr. Bacal believes I advocated affection to be “essential for therapeutic effect.” However, I indicated otherwise: “I do not claim that affection alone can suffice for therapeutic process, and it is possibly not always necessary for a successful treatment” (Perlitz, 2016, p. 251). Dr. Bacal’s conscious perception of Kohut’s gesture may not have included affection. However, I believe that undergirding that moment there was a “vitalizing foundation” (p. 251) of Kohut’s affection, which Dr. Bacal himself alludes to when he says, “I had no doubt about Kohut’s affection for me, his caring for me.” This vitalizing foundation of affection contributed to making Kohut’s gesture possible, and without this foundation it would not have happened. Lastly, I reference excerpts from Dr. Bacal’s recent article which indicate that he and I are largely in agreement as to the issues I raised in my 2016 article.

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