Coasting in the Countertransference: Conflicts of Self Interest between Analyst and Patient

Irwin Hirsch.jpg

This was a holiday goodie and I wrapped up my notes on this non-fiction literary work right at the cusp of 2017's last mercury retrograde & full moon. It matters to highlight this as my mind brings me full circle to the emergence of my curiosity towards analysis. Lets venture to the past..... not only was I mortified at the aspect of one submitting their mind to an attuned other, but also submitting oneself to different self states within an array of emotions and thoughts that [with most] would prefer to stay buried in the unconscious.  Yet I jumped into the abyss; it brings to mind the David Bowie scene in Labyrinth when he sang Within You. And yet, Dr. Hirsh catapults his intimate experiences front and center pertaining to that exact maze of understanding oneself as an analyst, supervisor & colleague. Kudos to analyst out there - there is nothing easy about the work that you do.

To get knee deep in "the shit" Dr. Hirsh unsheathes aspects of the profession that are cringe worthy and at the core, the humanness of the analyst! In my [Haitian] heritage it’s equivalent to shinning a spotlight on the mortality of a mambo or houngan, it’s already implied! Yet the implicit intimacy of the helper-helpee dyad does not call for the human attributes of the professional to rear an ugly head. Dr. Hirsh utilizes a variety of clinical examples to highlight his authentic self and ways in which striving for preferred relational configurations, emotional needs & finances seep into the work.

I related to the clinical examples in one form or another and gawked at the notion of parallels within the supervisory role (I took detailed notes in that specific area!) The self interest that was soapboxed rang no alarm,  despite being on the receiving end of the couch. As a psychotherapist with a curiosity towards contemporary psychoanalysis, and as a clinician practicing through relational and interpersonal foundational beliefs I truly believe that a vast majority of clients (I prefer to use the term client, as patient overtly implies sickness) know of the “self interest monster”, especially within pop cultures depiction of mental health professionals present day. With shows like Gypsy, In Treatment, Couples Therapy, & Iyanla Fix My Life individuals are getting a taste of therapy from their own couch before stepping into their 1st session. The times are changing, especially with an influx of millennials, people of color & 1st generation Americans experiencing an increase in access mixed with a decrease in stigma towards mental health services. 

Dr. Hirsh stepped forward with honest communication and laid the footwork for open discussion pertaining to why and how coasting bewitches both parties in the room; along with explaining the impact that choices therapists make (or choose not to) impact clients. In a field saturated by individuals who have devoted their time, energy & funds into knowing themselves, how can the aspect of self interest be so shocking to readers within the profession? Is it shocking? There’s a narcissistic air within the tone of the literature that is unyielding and captivating in its allure because of those 2 questions.

I enjoy reading the last page of a book and being disappointed that it has ended. There’s an insatiable desire to read more of Dr. Hirsh’s work while sitting in this one a bit longer. He will undoubtedly rest in my mind during moments of emotional withdrawal, pre-initiation of disequilibrium inducing anger in sessions and aha moments of profound insight at the curtail of an enactment. I am in awe at how delightful of a read this was.

*I shoot my thank you into the ether to Ms. Griffin for sharing.