Catastrophic illness in the analyst and the analyst's emotional reactions to it

The author reviews the fact that there is very little literature available on catastrophic illness in the analyst and the analyst's emotional reactions to it, compared with other topics of interest. Some of the factors suggested to account for this are exhibitionistic concerns, concerns about one's privacy (including psychic privacy), embarrassment related to countertransference, and concerns about losses of referrals if colleagues perceive the analyst to be impaired. The author then draws a distinction between the emotional life of analysts and countertransference, and discusses how and why he defines them differently. The major part of the paper then goes on to discuss two major technical questions in considerable detail: (a) whether or not to give factual information to patients about one's condition, and (b) the manner in which the material is introduced into the analysis. A number of case examples are cited. The author closes with a discussion of the question of the pros and cons of reporting on the experience immediately versus waiting for the passage of time.