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Ginsburg, S.A. (1992). Contemporary Psychoanalysis. XXVII, 1991: The Impact of the Therapist's Life Threatening Illness on the Therapeutic Situation. Gloria Friedman. Pp. 405-421.. Psychoanal Q., 61:511-512.
Psychoanalytic Electronic Publishing: Contemporary Psychoanalysis. XXVII, 1991: The Impact of the Therapist's Life Threatening Illness on the Therapeutic Situation. Gloria Friedman. Pp. 405-421.
The author examines her experience as a therapist during, as well as in the years following, her bout with cancer. She has remained well since the initial episode. The paper is of note, both because it discusses a topic about which there is little literature, and because it raises complex ethical and countertransferential issues. At the time of the illness, patients were told only that there was "a family emergency," and none ever became aware of her condition. Friedman concludes that she was not "in collusion" with her patients to deny the cancer, but rather that she had managed "effective and unambivalent compartmentalization." She contrasts her reaction of increased satisfaction with her work, with those of others who have reported resentment of patients' dependency or envy of their good health. Within the next few years after her illness, the author saw three new patients who had had recent losses due to cancer. One remained in successful treatment. The second had lost several relatives to cancer and was facing the imminent loss of yet another; Friedman felt unable to tolerate the prospect of hearing about all these ongoing tragedies, and
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declined to work with the patient. The third patient fled treatment after being informed of the author's illness.
Three patients in ongoing therapy discovered the existence of the author's cancer, two accidentally from outside sources, and a third because Friedman appeared to the patient to know so much about cancer. For all these it seemed to be "grist for the mill," and led to transference analysis. The author intends to inform all future patients "who have experienced the death of an important person through cancer," because "to have them face the same possibility with me is more than I can be a witness to or partner of."
Discussion includes the differences between the classical analytic and interpersonal traditions. As a representative of the latter, the author believes that insuring the continuity of the analysis is more pertinent than concern for interfering with it by veering from neutrality and abstinence. She concludes that the coping skills of the therapist will set "the stage for what will or can transpire in the analytic situation."