(2018). IJP Open, 5:22
Being invited by the patient to enter the crucial moments of her life as a trusted eyewitness, indeed, to enter her mind, is a rare privilege. It is a matter of confidence. Considering the issues that are usually at stake, it almost implies a childlike trust on the part of the patient. Abiding by the rules of the game, as it were, the analyst must adopt an empathetic, though strictly non-interfering, attitude. Resisting the temptations of transference, he must hold his hand, observe, and make room for mutual reflection. To be of any benefit to his patient, he must be patient. He is neither a lover nor a friend. Nobody expects him to take action or deliver practical recommendations from day one of the psychotherapy. No, his professional specialty is recovery through conversation. Accepting the invitation to offer his services, his assignment is to support an inviting presence and facilitate a liberating process in another person, building up healthy self-knowledge and self-confidence. The goal, as always, is freedom. – A formal psychiatric diagnosis (e.g., “borderline personality”) tends to narrow the field of investigation. Of course, that is undesirable from an analytic point of view. The diagnosis may thus restrict the explorative initiative of the analyst and impoverish the psychotherapeutic process itself. For psychoanalysis to work ideally, tacit restrictions imposed by diagnostic prejudice must be absolutely banned from the sessions. – With regard to Lotte, she trustfully invited me to explore her evil past together with her. I accepted the invitation and set out on an expedition into her mind as her loyal companion. Avoiding the vices of self-righteous or know-all attitudes, as I sincerely hope, I kept her to her intentions of getting to the bottom of her problems once and for all – and invited her to reflection. It is a fruitful experience for the analyst to develop emotionally in parallel with his patient. The interlocutors of patient and analyst may grow – or mature – simultaneously, thanks to the same psychotherapeutic process. I believe that I had that experience myself, working with Lotte. But then again, does it not always work like that?