EXCERPTS FROM MY "A PATIENT'S EXPERIENCE OF HIS ANALYSIS"

 A Patient’s Experience of his Analyses By Michael Roloff This excursus seeks to explore, from an analysand’s perspective, the transactions between analyst and patient. KEYWORDS: Patient-analyst interaction; dreams as communications; analysis of the analysis; second analysis. -+ -- “La Vida est un sueno,” Calderon “The gradual passage of time [Lange Weile] is the Dream Bird that Hatches the Egg of Experience.” Walter Benjamin, from the essay on Leskov, On the Writing of Fairy Tales. [1] What brought me into analysis? I had always been intrigued - not that the patients I knew [1], some of them graduates, proved enticing, mostly the opposite, to engage in what seemed like a mysterious undertaking, and whose mysteries, the more deeply familiar I became with them, become, in important respects, no less so, no matter that you seem able to account for them in technical and conceptual terms. For one year I had even lived with someone who had returned to New York to enter analysis full time about the time she moved in with me. We did not talk about her analysis, she neither reported what transpired in the sessions, nor did I make inquiry. I had a vague sense that her being in analysis with a man constituted a triangle of some kind; however, I had far more serious immediate triangular competitors to worry about with the then very avant-garde girl. [3] I had edited books in the field, Tilman Moser’s Years of Apprenticeship on the Couch, [4] whose revelations - if not directly opposed as contrary to the ethos of the discipline in the late 70s, went, best as I recall, unappreciated except by one member of the Southern California Chapter; and I got a vague sense of the discipline as being rife with sectarianism, which I knew other disciplines to stop being once certain fundamental matters were settled; as well as Ernest Bornemann’s Psychoanalysis of Money. [5] Yet I had not read any of the fundamental texts, such as the Interpretation of Dreams or The Ego and its Mechanisms of Defense or, except in college, any Freud aside Civilization and its Discontents and perhaps a few of his case histories; not that I had not been an avid but helter-skelter reader of lots of matters psychological since my highschool days. While I was an editor someone had tried to prevail on me to publish a Hans Kohut Reader, it was the same person who would button hole me at lampposts about “object relations” – as though I knew what he was raving about! – texts that seemed obscure at the time. I was living in New York and so was exposed to matters analytic. The concepts were concepts, upon the experience they acquired the weight of experience; without the weight of experience they would have remained mere concepts. I only learn from my wounds. Now that I have a fair amount of the experience I sometimes feel uneasy about wanting to confine it within concepts. But I have little choice, don’t I? At the time I entered analysis, I was wondering about my judgment, especially about most of the people I became involved with, the chances I was taking, my over-optimism, my ability to do "everything on my own" - that is how I would put it then and still do now except for the proviso that my doubts could not have been better founded; the sense of apprehension was vague, but the consequences of my misjudgments, that much I knew, required safety; a certain kind of revolutionary life was taking its toll. Once I reached my decision, and decisively so, I contacted an author whose dissertation on stage fright I was going to help edit into a more accessible book, a manuscript it appears I understood. This man, a candidate, who seemed frighteningly deferential to the discipline, said to give someone by the name of Dr. Eissler a call. While dropping off a manuscript which we could not publish, a possibly prescient editor at this other publishing house, just happened to slip me a copy of Janet Malcom’s The Impossible Profession – that indeed proved intriguing. [6] Given long periods in early childhood spent under protective custody in a considerable variety of spacious rooms with high ceilings, sometimes filled with shelves upon shelves of books, fairy tales and sagas interesting me especially, Dr. Kurt Eissler's sitting room proved instantly attractive. The man was also of the height, age and courtesy that elicited European childhood memories. At our second meeting Dr. Eissler mentioned that, unfortunately, he always had a hard time remembering what people, under these circumstances, had said the first time around. Dutifully – a bit puzzled and annoyed, sitting en face - I recounted what I thought was pretty much the same family saga. Who knows whether my slight annoyance was what altered the telling? - Perhaps Dr. Eissler kept notes. This being my first serious conversation with an analyst [excepting the one who made a reluctant draftee into 4 F for sleepwalking in his late teens; and who, after hearing me out, pronounced me not all that incorrectly a fantast], who was I [there was one problem right there, one of them, anyhow] to pipe up in surprise - courtesy, too, which inhibition certainly was not always evident in my dreams; a certain over passivity, too no doubt. At the end of the second meeting, Dr. E. stated that there "was a lot there," to which statement - ominous had it come from an oncologist - I hadn't the faintest what to reply, though I could have asked for enumeration: not that, if the enumeration had been spelled out in terms with which I am now familiar, would have meant anything at all to me: borderline maybe, though that analytically so lazy, self-satisfied term had an entirely different significance for me then. [7] Yet how right Dr. E. was in retrospect, and what did I want “man or woman, dog or elephant” - it is good to remember that Joseph Haydn wrote his Surprise Symphony for his sleepy Austrian audiences with an occasional drum roll. I said I wanted a man, thoroughly experienced, about his age, which meant about thirty years my senior, and what about him - my annoyance of an hour ago apparently forgotten – “couldn’t you take me on?” Dr. E. averred that he only treated adolescents, whereupon I failed to say, for example, that a recent girlfriend insisted that I was really Peter Pan; or: “I will prove to you how much of an adolescent I am” - and, later, when I began my real reading in the field - I appreciated Dr. Eissler's work: yes, he would have managed that part of me very well; how he would have dealt with the part of me that since a very young age was as ancient as he, is another matter. He said once he had found someone he would give me a call. Having noticed in Dr. E.'s generous sitting room titles by an author whose work I published and another of whose masterpieces I was about to translate, I seized the opportunity to redress the conversational imbalance by making inquiry of my own. Dr. E. mentioned that he didn't cotton to Peter Handke – it was the early work - as I could understand once I read his writings and became familiar with his origins and tastes; whereas I shared his, he did not share my extension of them, but his so frankly expressed absence of a possibly shared interest then made it easier to forego this preferred high-ceilinged, literate venue with the spell that my grandfather cast on him from the past, telescoped though the age, by then, was roughly by half! The discovery of the significance of what is called “screen hungry” lay well ahead of me. Within the week Dr. E. called, to say that his first choice was over-booked, his second a man, experienced, not his age, who however knew German. With my then firmly held notion, however I had arrived at it, that analysis meant a near total preoccupation with one’s childhood, I knew the time would come when the relationship would have to be conducted in the language of childhood or, for the least, that the analyst needed to understand German, if not Plattdeutsch [Lowland German], which is like Nederlansk [Dutch], akin to Old English and a derivative of Gothic. I sensed this without understanding anything of regression. I had a notion, however acquired, that analysis involved an archeological exploration. Dr. E. also said during that telephone conversation, and the emphasis he put on the word was not as I had heard it before: “Well, we just have to make another compromise.” That was not a word I particularly liked, but one that I had never come on in reference to anything having to do with psychoanalysis, no matter that, in relationship with, for example, the partners at the publishing firm I invariably tried to find a fair way of splitting the differences; or, more typically, giving up half to get one real half for myself. Meanwhile, of course, I have a very different appreciation of what constitutes compromise than I did then, especially of the compromises that are reached in the strata where dreams are formed, tense as those, too, may be. Not that I had not the opportunity to say that I was not in the business of compromises when it came to my psyche before Dr. E. mentioned that I ought to send him a postcard down the line and let him know what I thought of Dr. X; he wasn't really sure about him. Far more confused, then, than however I may be now, I - with physicians in his family background and who had known quite a few physicians in my life, to all of whom, except for the occasional painful or mistaken moment, I had had a positive relationship, a me who felt that writer physicians were the best writers, and who had considered becoming a physician myself - had certainly never been referred to a doctor by a doctor about whom the good doctor had his doubts. But if the purpose of the suggestion was to put a sometimes extremely nonchalant me on an alert, an alert a preferably also sleepy me did not want to be in, that purpose, as well as the puzzlement introduced by the “second take,” to use a term from the recording industry, could not have been better served. I sent Dr. E. his postcard about the time that Dr. X announced to a baffled me that the “transference” had set in. I might [again] have asked Dr. X, what he was talking about, to me who, by then, had been talking away on the couch for some months. The word rapport I would have understood. “Yes, best as I can tell, he seems o.k.” But how and who was I to assess an analyst, as compared to someone who botched an operation? As to finding Dr. X to be o.k.: more on that anon. One matter that Dr. E. handled with seemingly greater aplomb was the question of money. Asking him at the end of the second hour how much I owed, he replied, “Oh, I never really know how much to charge for this kind of consultation,” which saying once again nonplussed someone who had paid fair sums to two fine European physicians during a twenty year period in New York, and who knew about set rates. However, the sum that, on some thought, I found fair recompense for these two hours, then became the sum set by Dr. X, obviating need for any haggling between us, an elegance that I, with a certain, typically European, certainly also class-based, distaste of talking about money, much liked. However, the sum that I – who had a thing about being “fair,” which automatic response, on later reflection, I concluded I had learned from my mother who indeed had always been as fair as she could be and had suffered the consequences – then decided was fair recompense for the two hours spent with Dr. E. was less than what I could initially afford and than the average going rate in N.Y. at that time; and it was less for the very reason that I found Dr. E., as a physician, odd; and so, had I not had a thing about being fair I might even have sent him considerably less for those two hours. By colluding with Dr. E. in arriving at this figure [I happen to be the not that unusual person who detests it if people he knows are speaking about him behind his back, and then are not up front to me about what they have said] all for the salutary sake of not interposing the hurdle of haggling at the opening of the race, much appreciated as that happened to be in my case, Dr. X was depriving himself. For all that Dr. E. knew, I - the co-publisher of a small firm - might be privately wealthy; the ambiguous mode of my then usual combo of jeans & Brooks Brother’s herringbone jacket, was not susceptible of immediate interpretation, not that this person, who had explored the heights and the bowels of NY during the twenty years I had spent there, could not have enlightened him if he had asked. At any event, the aborted opportunity to discuss the fee, and matters relating to money, and what that might reveal, obviated anything but this one chancy peek – into an apparent realm of agreeability - into that so very revelatory realm. Moreover, the maneuver of establishing a sum by fiat, as it were, infantalized me, taking this decision out of my hands and the realm of discussion. Not that I could not have piped up – but I was getting a good deal, my analyst was coming in on the cheap! However, I regret not pointing out, at the time that I was so agreeable, that I really wanted to pay the average going rate. Nor that the time wouldn’t come when the fee that I myself had accepted proved a real burden, and that I discovered that some occasional ways of being generous covered up an occasional niggardliness, when the pocket book became tight, that did not fit at all with my self-image! It could be said that the two parties, analyst and analysand, on the once, were entering a thicket of assumptions, which of course could be cleared up. I may have been far more naïve in the early 80s than I am now, but however sleepy or head in the clouds I may have appeared, I was not a complete dummy. It is my guess that maneuvers of the kind, even the last that Dr. E. worked on me, have a deleterious consequence for the reputation of the profession. There is a fine saying by Alfred Bion, to the effect that the encounter of any two persons is like that of two storms: so very much – or does not - come into play, as it so evidently did immediately in Dr. E.’s and my weather systems, with consequences for the latitudes that Dr. X and I would travel together. Counter-transference existed before it was called that and is a two way street, or as the case may be, stomach. To take unfair advantage of the power of insight that the analyst enjoys on first encounter in the dyadic relationship is bound to be disadvantageous to the treatment, as it is to any serious relationship. On the other hand, both sides can always put all cards on the table at any time. # After talking to Dr. X en face for eight sessions at a kind of beehive or apartment complex filled with shoe boxes full of analysts [which, moreunder - in lieu of moreover - housed the office of a nattering, delinquent author of mine, a would-be analyst who had infiltrated the complex’s basement; and who, at some point served nicely, in a dream, as a heavily overdetermined day-residue for “the bad analyst”! - “Yes, right here, in your basement. Could I ever tell you stories! Funnee!”], Dr. X allowed that "I didn't understand my story," an assessment with which I had no quarrel since I wasn't even sure that I needed to have a story, story teller though I was, preferring to tell everything, including this communication, mostly in story form, but which assessment, in retrospect, now that I know how comparatively complicated a story it may be, I emphatically endorse - and so why didn't I lie down on the couch? And after promptly doing so, I well recall the sound of surprise emanating behind me the first time I - who had no idea patients can be reluctant to submit to the couch – lay, oh so eagerly down on the couch: no, not to fall asleep - as a recently discussed case of a wonderful safety-and rest-seeking patient did - but for the adventure to begin; an adventure on the couch, what dangers could it pose, particularly to someone like me who loved recumbence? Fly me to the moon! And, in no end of instances, the little noises, guffaws, sounds of surprise, groans of despair or the laughter emanating from behind me were as important as Dr. X’s interpretations; if only for reasons of maintaining some spontaneous living contact within what, at times certainly, seemed like going down four thousand feet into the Guaymas Trench in a bathysphere - something that I, whose dream metaphors were drenched with maritime imagery and who had spent time at sea, would actually do about ten years later in that kind of utter slightly rustling stillness, child’s play compared to an analysis, nor in the instance of that adventure entirely by my lonely self; although, with time, and in some many respects entirely egotistical, I began to have an inkling that the experiment was a mutual one, that we were in the bathysphere together, as I would be in the future with a different kind of expert whose attention, however, hovered on very different kind of exotic fauna and flora and possible difficulties, at 4,000 feet under sea. However, for long stretches, during the analysis, I became most, if not too, comfortable on the refugio couch; there turned out to be an analyzable highly egotistical twist to that, too. During another, very long stretch, the couch turned into a rack, which a tad of masochism can make bearable, as can a touch of residual steeliness; curiosity, and love – since that was not to be had in that situation – stubbornly transformed into the love of understanding, however, being, in my instance, one of the chief motivators to seeing the process, ultimately, through most of its viscous and obscure mediaeval periods. Freud gave as reason for his preference of having patients on the couch that he did not like to stare them in the face for long periods of time, which makes a kind of perfect “natural” sense, although he of course knew already about regression from Hughling Jackson well before, if that is what it takes to know that people relax and regress and are more open, usually, once they are recumbent. Freud makes no comment as to the patient’s preference and what effects that may have on the treatment; nor, best I know, how that changed emphasis from the sense of sight to that of hearing - the first sense to develop intrauterine – alters the nature of the relationship between analyst and analysand. Bertram Lewis’ notion of the “dream screen” of course was not yet the succinct explanatory model for the state I would enter. - I, for one, departed the first analysis under the impression that I had absorbed Dr. X’s ear - I could listen so well into myself, especially into the well-springs of my dreams; with further travels, with a different guide, ahead of me. # The first two weeks’ eight sessions with Dr. X - and never again, except for those instantly formalizing arrivals and leavings at which, turning around for that last look, I caught sight