Bromberg, who has written cogently on the patient’s need
to stay the same (not give up a part of himself or lose a sense of who he is)
while changing, cautions the analyst against attempts to alleviate a patient’s
depression without first respecting that depression is not merely an affective
state but is also who the patient is:
“For many people [depression] is a self-state with its own narrative, its own
memory configuration, its own perceptual reality, and its own style of
relatedness to others.” Because the patient has a need to preserve the self and
self meaning, he cannot easily allow the analyst to destroy a part of his
personal reality as if it is meaningless.
By giving in to a patient’s demands in an effort to relieve
him of his depression the analyst attacks the patient’s self and speaks to the
analyst’s incapacity to bear with him his suffering. Gratification of patient’s
needs (in attempts, for example, to relieve depression) can become “a form of misrecognition, …evidence to the patient that the
analyst is unable or unwilling to authentically ‘live with’ the patient’s state
of mind.” While “patients in general need soul-searching emotional openness from
their analysts” the analyst’s inauthenticity makes it difficult for her to give
the patient what is actually needed—genuine mutuality— and so the patient
understandably responds by pushing the analyst “to the edge” in the hope of
helping her change into someone more capable of genuine mutuality.
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