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Gutheil, T.G. (1979). Discussion of “Time and Timekeeping in Psychoanalysis and Psychotherapy”. Am. J. Psychoanal., 39(4):329-333.

(1979). American Journal of Psychoanalysis, 39(4):329-333

Discussion of “Time and Timekeeping in Psychoanalysis and Psychotherapy”

Thomas G. Gutheil, M.D.

Dr. Ingram's remarkable paper combines thoughtfulness and fascination in a stimulating manner. I am certain you will agree that Dr. Ingram has admirably realized his self-imposed requirements of humility, curiosity, and playfulness; in discussing his paper I could do no better than to adopt these standards as my own and to be guided by his attention to the theoretical, clinical, and practical elements of time. Before doing so, however, I shall briefly discharge the discussant's obligation to attempt to place in some perspective the paper under discussion.

Though the subject matter would seem to invite lofty but empty philosophizing, Dr. Ingram effortlessly avoids this temptation by anchoring his exploration in the solid bedrock of clinical reality. Clearly, only someone ultimately a clinician could have so insightfully interwoven the themes of time, neurosis, and culture, with the treatment vignettes that demonstrate those rather abstract forces in specific action during the treatment process.

But to look at the converse: Dr. Ingram has not confined his exploration even to the boundaries of the clinical, broad though those bounds may be; he has shown us how the clinician first focuses on a technical problem in the treatment of patients (in this case, timekeeping) and then is stimulated to lift his gaze to encompass the larger contexts, not only of the psychiatric profession, but of the human experience. We thus share with the clinician-scholar the excitement of the creative process, the free movement from clinical to theoretical, from concrete problem solving to philosophical inquiry.

A discussant who finds grounds only for praise in the paper at hand is in danger of being thought uncritically sycophantic; to avoid such opprobrium, I have painstakingly sought something for which to chide Dr. Ingram and have fixed on the fact that I feel he gives inappropriately short shrift at the end of his paper to the matters of alliance and empathy. I should like to begin my discussion proper with these concepts as they relate to time and time keeping.

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