Inside Out: The State of the Analyst and the State of the Patient

Abstract

This paper presents my work with a man before and after my undergoing an emergency, life-threatening surgical episode, and subsequent experience of living with a temporary colostomy, that shifted me to a more ungrounded, bodily aware, vulnerable, nonlinear, spontaneous and risk-taking, and affectively intensified “right brain” state. My story represents one instance of how the contingent nature of the analyst's life and existential exposure, and the various chancy life circumstances governing the analyst's self-state, may constitute an impingement on clinical process with potential for inadvertent positive or negative impact on the therapeutic relationship and work. Much has been written about the causes and consequences of shifts in the analyst's self-state induced within the relational dynamics of the transference-countertransference matrix. Here I specifically consider that side of the intersubjective therapeutic equation generated by the effects of the analyst's own state on the patient and the dyad's interactive process.

Notes

I am grateful to Anthony Bass, Philip Bromberg, Hazel Ipp, Andrea Massar, Maureen Murphy, and Barbara Pizer for their helpful comments as I developed this paper, an earlier version of which was presented on an invited panel at the Spring Meeting of Division 39, Toronto, April 20, 2007; at the CABP Conference, “‘The Client and I’: Relational Dilemmas and Opportunities in Psychotherapy,” Cambridge, UK, September 7, 2007; and at the Israel Psychoanalytic Society, Tel Aviv, November 27, 2007.

Additional information

Notes on contributors

Stuart A. Pizer

Stuart A. Pizer, Ph.D., A.B.P.P., is a Founding Member, Supervising Analyst, Faculty, Board Member, and former President, Massachusetts Institute for Psychoanalysis; Assistant Clinical Professor of Psychology, Harvard Medical School; Past President, International Association for Relational Psychoanalysis and Psychotherapy; Associate Editor, Psychoanalytic Dialogues; Visiting Faculty, Psychoanalytic Institute of Northern California; Visiting Faculty and Advisory Board, Toronto Institute for Contemporary Psychoanalysis; Corresponding Member and Visiting Faculty, Institute for Contemporary Psychoanalysis, Los Angeles.