“Where does she get her analytic patients?” Th e plaintiveness of Paul’s
question startled me. Paul is a respected se nior psychoanalyst, and here he
was anxiously wondering aloud how his colleague was managing to sustain
a properly psychoanalytic practice in the quick- fi x, medication- centered
world of managed behavioral health that envelops them both. But it was
not the question itself that struck me— it is one that is on everyone’s mind
in his world— so much as the pointed anxiety that surrounded his idea,
perhaps his fantasy, that there was some “where,” some source, some place
where the patients came from, and the implication that she knew some-
thing he didn’t, she had access to something he didn’t. “She’s never sent
me a single patient in all these years,” he trailed off , implying that his col-
league was hoarding the goods. “She has a full analytic practice, you know.”
A pall fell over our discussion, one that enveloped me time and again as I
interviewed psychoanalysts about their discipline, their work, their com-
munity, and as they told me, time and again, that their profession was in
crisis—“though not for the relational people.” Whoever they were, their
situation was said to be diff erent somehow. I remembered my interview
with Paul’s “relational” colleague now, how she had told me “everything I
do— it’s not about technique, it’s all about the relationship, the real relation-
ship. Th e analysis basically is the relationship.” Th is fi gure of the relation-
ship, the real relationship, loomed large in my interviews with psychoana-
lysts, an image of warmth and plenitude surrounded by pathos, saturated
by fear of failure and by envy of the other’s fortune. How might we under-
stand the communal elaboration of a state of precarity and crisis so steadily
attended by a pregnant sense of the plenty and presence embodied in this
idea of the real relationship?1
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