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Development of a self-analytic function has historically been a goal of psychoanalysis. This article draws on interviews with former analysands to examine ways in which self-exploration continued after analysis. Former analysands who did not report ongoing self-exploration had not necessarily failed to benefit from analysis, nor had they not continued to benefit and grow after analysis ended. The author reflects on different ways of assimilating the analytic process and the analytic relationship, and self-analysis as a criterion by which to judge the success of analytic outcome is reconsidered.

An important area for psychoanalytic study is the significance for intrapsychic life of important events taking place in the community of which analyst and analysand are a part. September 11, 2001 provides a vantage point for examination of questions that arise from looking at the interrelationship between current environment and intrapsychic life. Two cases are presented as a focus for discussing the interaction of the memorialized past and occurrences in present reality, the significance for an analysis of analyst and patient sharing the same experience, instigations to progress that a current event may provide and the ways in which communal experience influences intrapsychic life. As a part of the discussion, we ask as well in what ways a common experience may be shared, and the significance of radically different meanings that the same event may have for analyst and analysand. We also pose the question whether the differences and similarities, each in their own way, may serve as progressive forces in the analysis.

In this paper, I wish to illustrate how working with a patient who had a certain kind of narcissistic difficulty led me to develop particular clinical strategies to facilitate the development of a sturdier sense of self, greater affect tolerance and modulation, the diminution of harshness of her superego, and the ownership of projected parts of herself, and to decrease paranoid ideation. I call upon concepts from various theoretical schools of psychoanalysis to make sense of the dynamic intricacies of the patient's psychological organization as they revealed themselves in the analytic process. These conceptualizations of the patient's difficulties and of clinical interventions to address them result in a hybrid theory of both theory and technique. What transpired in the clinical work also led me to propose an additional way to understand this kind of patient's difficulties with accepting interpretations or any view that differed from the patient's subjectivity. I am proposing that 'otherness' itself, rather than only specific conflictual aspects of the self, is disowned. It is the analyst's empathic stance toward all that is repudiated--the specific disowned aspects of the self and 'otherness' itself--along with empathy for the patient's conscious state that will enable reinternalization and ultimately healing.

Patients' reading of their psychoanalysts' papers about them as a vehicle for psychoanalytic work is a relatively new phenomenon in the field. Over the past five years, reports of analysts' employment of their writing in this fashion have begun to appear in the analytic literature. This paper presents clinical illustrations of this specific use of analysts' writing. These illustrations were drawn from interviews with analysts who published clinical articles in Psychoanalytic Dialogues between 1995 and 2003. The author considers some of the clinical and scientific implications of this use of papers written for publication.

When analysts write about patients, they find themselves in a position of conflict. Their first loyalty is to their patients and maintaining confidentiality. However, they are also committed to advancing scientific knowledge in the psychoanalytic field. The attitudes and practices of 36 analysts residing outside the USA, who published articles using clinical material from their patients, are reported. Their attitudes and practices are compared with those of 30 author-analysts residing within the USA, who had been previously interviewed. Among the 66 analysts, geographic region was not a basis for distinguishing differences in attitudes or practices. Slightly more than twice as many analysts use only disguised material as regularly ask permission of their patients to write about them. The decision to use only disguise is somewhat more frequent for analysts who reside outside the USA than for those living within it. Analysts around the world are increasingly concerned about the accessibility of published material. More analysts have come to believe that it is necessary to ask permission before publishing material. Some analysts also believe that the request itself, and the patients reading written material about themselves, focus issues that are central to patients' characters and conflicts that can then be explored analytically.

A focus on the match between patient and analyst places attention on the dynamic effect of the interaction of character and conflict of both participants on the process that evolves between them. Match is neither a predictive nor static concept. Rather it refers to an unfolding transaction that itself shifts and changes during the course of analytic work. The treating analyst's perception of the effect of this match is by necessity limited by the analyst's own blind spots and other countertransference phenomena. Reporting the analyst's clinical experience to an analytically trained observer, external to the dyad, may broaden the analyst's perspective. Using the lens of the match, a colleague in the role of supervisor, consultant or peer can provide feedback from which the analyst may acquire insight. As a result of this process, the influence that the participants' similarities and differences have upon each other becomes clear to the analyst. This awareness, in turn, may lead the analyst to appreciate the effect of the analyst's stance of distance or closeness and to evaluate whether at this phase of treatment it is beneficial or detrimental to the analytic process. Clinical illustrations of the effect of the external observer's feedback in relation to the patient-analyst match are provided.

A focus on the match between patient and analyst places attention on the dynamic effect of the interaction of character and conflict of both participants on the process that evolves between them. Match is neither a predictive nor static concept. Rather it refers to an unfolding transaction that itself shifts and changes during the course of analytic work. The treating analyst's perception of the effect of this match is by necessity limited by the analyst's own blind spots and other countertransference phenomena. Reporting the analyst's clinical experience to an analytically trained observer, external to the dyad, may broaden the analyst's perspective. Using the lens of the match, a colleague in the role of supervisor, consultant or peer can provide feedback from which the analyst may acquire insight. As a result of this process, the influence that the participants' similarities and differences have upon each other becomes clear to the analyst. This awareness, in turn, may lead the analyst to appreciate the effect of the analyst's stance of distance or closeness and to evaluate whether at this phase of treatment it is beneficial or detrimental to the analytic process. Clinical illustrations of the effect of the external observer's feedback in relation to the patient-analyst match are provided.