Studies in listening: when patients talk about their patients

The literature is curiously silent about special challenges in the analysis of psychotherapists, including the interactive tensions that result when analysands talk about their own patients. When analysands talk about their patients, the analyst may be deflected away from a focus on the analysand's intrapsychic experience by transient identifications with the analysand's patient and by multiple identificatory processes which press the material away from mutually observed metaphor toward enactment and actualisation. Using detailed illustrations of the clinical process when patients talk about their patients, the author illustrates the manner in which the analyst's listening itself may be drawn into the process of enactment and explores how transference-countertransference interactions alter both the analyst's and the patient's listening. These interactions and identifications are compared to the triadic identificatory processes that lead to what has been called the 'parallel phenomenon' in supervision. Because the challenges that arise when patients talk about their own patients may be of more general significance, they merit further study.