An Offer I Could Refuse: Analytic Regret and Its Vicissitudes

Abstract

This paper traces my personal experience of a missed opportunity with a patient as it reverberates within me across decades. I discover that my experience is transformed, in part by the process of writing, from dissociation to guilt, then to curiosity and regret. Regret is presented as a more complex emotion than guilt in that it is less characterized by self-reproach and reflects some measure of acceptance along with disappointment and sadness. Writings of Aron, Josephs, Searles, Slochower, Winnicott, and others are employed in the development of this theme.

Keywords:

• enactment
• gift
• guilt
• regret
• trauma

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Notes

¹ My experience with Rafael and its connection to my mother bring to mind Freud’s (1917, p. 249) well-known statement regarding melancholia, “The shadow of the object fell upon the ego.”

² Searles (1966, p. 321) suggested that we fear destroying our patients with our anger so suppress it and, consequently, our anger “grows, and we hate the patient for our unfreedom, and we feel guilty for our hate.” Searles goes on to argue that we cannot express our anger “for fear the patient’s image of us—and worst of all, our own image of ourself—as being omnipotently and unambivalently loving, be irretrievably lost.” Here, then, Searles is spelling out a problematic aspect of an impossible, though widely held, analytic ideal.

Given Searles’ idea of the unambivalently loving and guilt-ridden analyst, I suspect that I may have worried about shaming Rafael, a man who already carried so much shame, and that worry may have contributed to my not talking with him about the possible meanings of his offer.

³ Another way to think about this is that Rafael might have unconsciously refused to formulate experiences of me he would likely have found intolerable or unacceptable. He might have inhibited his curiosity, or, in other words, dissociated (D.B. Stern, personal communication, December 6, 2020).

⁴ Slochower (2021) writes, “I want to underscore that when I speak of regret, I’m not speaking from a place of remorse, loss, or guilt. To the contrary, I’m talking about looking back and forward with a clearer eye. About how time alters, clarifies, and sometimes corrects our earlier understandings of things (p. 178).”

Additional information

Notes on contributors

Marc Rehm

Marc Rehm, PhD, is on the faculty of The Westchester Center for the Study of Psychoanalysis and Psychotherapy and is an Adjunct Professor and Supervisor at Adelphi University’s Postgraduate Program in Psychoanalysis. He supervises doctoral candidates in clinical psychology at Adelphi University’s Gordon F. Derner School of Psychology and Yeshiva University’s Ferkauf Graduate School of Psychology; consults to The Rosemary Furman Counseling Center at Barnard College; and is on the staff of Northern Westchester Hospital. Dr. Rehm maintains a private practice in New York City and in Mt. Kisco, N.Y.