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Morra, M. (2003). On ‘Miscarriages of psychoanalytic treatment with suicidal patients’. Int. J. Psycho-Anal., 84(4):1062-1063.

(2003). International Journal of Psycho-Analysis, 84(4):1062-1063

On ‘Miscarriages of psychoanalytic treatment with suicidal patients’

Mauro Morra

Dear Sirs,

I read Dr Gabbard's (2003) keynote paper with extreme interest. I not only appreciated the clarity of the presentation and the author's open-minded approach to the very severe issues concerned, but I also admired his being able to refrain from any moral judgement and from an easy technical condemnation. Instead, Dr Gabbard tries, I would say desperately, to understand what really went on in both the analyst's and the patient's mind, while also showing sympathy for the therapist who was in a very difficult time of his life.

No doubt the projective identification played a paramount importance in the analyst–patient relationship, as described in the paper, and I would like to elaborate a bit further on this point.

Who is the sexually abused child? In my opinion, it is the analyst. The patient is successful in projecting entirely her own experience of the incestuous relationship with her father into him. Through her seduction, she transforms him into the confused, anxious child, full of guilt and worry for his future, dirty and damaged (as we find in our clinical practice with the victims of incest). In some ways she destroys him, as her father previously had destroyed her.

Already, at the first interview, the analyst was struck by the beauty of the lady (‘the most beautiful woman he had ever seen’). When she confessed that she was attracted to him and asked for a different kind of relationship, he ‘clarified that dating was impossible because their professional relationship had already begun, and turning back the clock was not an option’.

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