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Schwaber, E.A. (2004). On: Miscarriages of psychoanalytic treatment with suicidal patients. Int. J. Psycho-Anal., 85(1):198-199.

(2004). International Journal of Psycho-Analysis, 85(1):198-199

On: Miscarriages of psychoanalytic treatment with suicidal patients

Evelyne Albrecht Schwaber

Dear Sirs,

In Gabbard's (2003) most interesting and evocative plenary presentation for the forthcoming IPA Congress, he describes the ‘tale of Dr N’ who had sought consultation for a sexual boundary violation that had occurred with his patient Jenny. Gabbard highlights the vicissitudes and implications of this kind of increasing, perhaps not unfamiliar, pressure. I would like to remark on Dr N's reporting of the very beginning of the treatment where it seems the seeds of difficulty arose.

Gabbard writes of Dr N's tale as follows:

Jenny was a deeply distressed 35-year-old woman when she first came to see Dr N. His first reaction when he saw her in the waiting room was that she was the most beautiful woman he had ever seen. As she began to tell him the saga of her tragic life, Dr N was moved. At one point in the middle of her tale, Jenny told Dr N she was attracted to him and asked if they could stop the meeting so they could date. Dr N clarified that dating was impossible because their professional relationship has already begun, and turning back the clock was not an option (p. 250).

Incrementally thereafter, in succeeding sessions, the patient's seductive pull on the analyst finally led to the boundary violation. Gabbard describes the ‘countertransference pitfalls’, including ‘the failure of mentalization and collapse of the analytic play space’ in his discussion of the ensuing treatment failure.

I believe it may be useful to reflect on the analyst's mode of listening and response in this first hour.

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