Holding on and Diving in: Reciprocity in a Therapeutic Relationship

ABSTRACT

This paper addresses the complexity of navigating the needs of the patient, as well as the needs of the analyst, particularly in relationally focused treatments where authenticity and emotional openness on the part of the analyst are so essential to the work. A case is presented in the context of the pandemic that had made the needs of the patient more urgent and the vulnerabilities of the analyst more apparent. It is the story of an unexpected invitation from the patient that I unexpectedly accepted, and how this decision impacted our work together. It led to events that changed the way that I felt—about the patient, about the treatment, and about myself—and helped me to recognize an unconscious problematic dynamic in our relationship. As a result, the patient also changed in unanticipated ways, feeling more authentically herself and also more able to connect with others. While this paper necessarily addresses concerns about working outside the frame, perhaps most important is its illustration and discussion of the surprising benefits possible from occasional shifts in the asymmetry of the analytic relationship. In this case, the patient’s opportunity to care for the analyst gave her a more robust sense of self, and enriched her capacity for empathy. Though the lessons for therapeutic practice arose in the chaos of the pandemic, they have implications far beyond.

KEYWORDS:

• psychoanalytic frame
• analyst’s needs
• mutuality
• therapeutic value of giving
• reciprocity in the analytic relationship

Additional information

Notes on contributors

Maria L. Slowiaczek

Maria Slowiaczek, PhD, is a psychologist/psychoanalyst in private practice, currently moving her practice from Ann Arbor, MI to Amherst, MA. She is on the faculty of the Massachusetts Institute of Psychoanalysis, Post Graduate Fellowship Program. She is an Associate Editor for Psychoanalysis, Self and Context, the Council Coordinator for the IAPSP International Council, and a member of the IAPSP Online Education Committee. She has been the Chair of the IAPSP Welcoming Committee for over 15 years.