Secondary Gain 007
The Anti-Advice Column of Parapraxis
Secondary Gain is an anti-advice column. It follows in the tradition of other psychoanalytic experiments that have opened up the consulting room using media: from Susan Isaacs’s advice columns in the interwar period and Winnicott’s radio broadcasts during World War II to experiments with radical radio, like Fanon’s understanding of the power of the radio in the Algerian Revolution and Guattari’s work on Radio Libre Paris in the late ’70s. Yet, in keeping with psychoanalytic principles, advice is not directly offered, and columnists don’t presume to offer treatment or cure or serve as a proxy for long-term care. Instead, three columnists come together to think with, and alongside, their questioner, who always has the final word.
Your columnists, writing under pseudonyms:
Dr. Harris C. is a psychoanalyst practicing in Brooklyn.
Dr. Lina Donato is a Kleinian psychoanalyst in private practice.
Dear Secondary Gain,
I’m a practicing psychoanalyst and a lesbian. I work mostly with the queer community. A patient of mine has recently been talking about a woman with whom she is in a casual sexual relationship. From biographical details it has just become apparent that my client is talking about a woman with whom I am also having casual (and enjoyable) sex.
I’m based in a small-ish city with a small-ish queer scene, but nothing like this has ever happened to me before. I’m horrified.
I know that I must, at the very least, privately work through the counter-transferential repercussions of this revelation. But is that enough? Do I need to break off my sexual relationship? Should I notify one or both parties? Should I terminate the analysis?
TL;DR: I’m an analyst sleeping with the same person as my patient.
Help!
Dear Analyst,
Do not panic. Nothing untoward has happened yet. You have done nothing astray in the treatment as far as you have written. You did not speak about the treatment, which is a matter for supervision. So, first step: nothing has happened yet. Second step: take the case to supervision. It is urgent that you focus not on yourself, nor your sex life, but on the case at hand. Supervision helps us find our clinical bearings. It can elucidate the direction of the treatment, the forest from the trees. This is paramount particularly when your personal life tumbles into your practice. It happens all the time, even in bigger queer scenes in places such as, oh, Brooklyn, where I happen to work. I have been in some sticky situations myself because many of my patients fuck each other, fuck my neighbors, fuck my friends, you name it—libido will find a way. Each time I have encountered an uh oh moment, supervision has helped me to relocate my analytic position, my orientation amid the swirls of fantasy, neurotic symptoms, and imaginary phenomena, what some might call “countertransference.” This is what we have to deal with all the time anyway in order to get down to the task at hand: analyzing.
The goal is to protect the treatment and keep the analysis going. You may notice I did not say “to protect yourself.” Nor did I say “to protect the patient.” It is a constant challenge not to think about yourself while occupying the position of the analyst in the discourse we call psychoanalysis. If you stand on the ground of guilt, anxiety, and defense in the treatment, you will likely have a problem. Remember, as far as you have written, there is no problem in the treatment. The treatment pertains to what is said and done in the encounter between analysand and analyst in the analytic discourse. When you leave your consulting room and enter the bedroom of a sexual partner out in the world, you are you. You are not the analyst. If you confuse these two entities, then the trouble begins.
In effect, you can do what you want with this third person. Cut if off, if it makes things easier to work as an analyst, no explanation necessary. Keep seeing her, if you want to, no explanation necessary. What would be an unequivocal mistake is to end the treatment. Why?
It is about the ethics of psychoanalysis, an ethics of desire that cuts through moralism, social contracts, and best practices. The right of way is ceded to the analysand. This means supporting her subjective agency. She can decide for herself what she wants to do if the three-way becomes a thing in the analysis, and it does not have to be a thing. In fact, I would encourage you to not make it a thing. You are not obliged to say anything about yourself or your personal life. You are instead invited to analyze the symptom that your patient has brought to analysis. It is always best to remain an analyst with your patients. All the things that pertain to yourself, including your sex life—those are between you and your analyst. Well, maybe this third person, too.
Stay the course, it’s worth the trouble,
Harris C.
Dear Analyst,
What a very intense time you must be having in your office these days! I think you are describing one of those instances in conducting analysis where the analyst’s own private, hidden intimate life comes to the forefront, is right in the room. Everything is on the line—or so it can seem. It reminds me of a time, some years ago, when an analytic patient of mine was describing in excruciating detail the therapy of one of her husband’s patients. I realized gradually and nauseatingly that the person being described was my own former lover. What made it so disturbing was that I sensed my patient knew and was spooling out the details ever so slowly—for maximum effect—to make me as uneasy as possible. She succeeded. It was very hard to do it, but I took up with her the way I thought she anticipated my discomfort in her telling me. We then could explore her need to be in possession of me/my mind, but always and only in this way.
It has been said that our patients know us and that they know everything about us. You might wonder if your patient knows this about you, “knows” that you and she are having sex with the same person. What happens if you assume that your patient knows that you and she share this sexual partner?
Oddly, there isn’t much to do about it—in a formal sense. You can’t tell your patient; nor can you tell your lover—you are bound, as you know, by confidentiality. You can end the relationship with your lover if you so choose. Mostly, I think, you have to bear the experience of listening to your patient talk with you about something that undoubtedly will stir up all matter of feeling for you and to think about this question of how your patient is getting inside you. Maybe it’s not quite like that—maybe I am superimposing my patient on yours —but it is worth wondering what your patient might sense about your discomfort, where your mind goes now in the sessions. Are you anticipating hearing about the lover, are you feeling excluded, jealous, anxious? How does this influence what you do and do not say?
Your patient has an investment in your reactions always, but maybe especially now. This is where I think the work is—nothing to do but continue to explore and examine your own responses. You are right that your own countertransference is key—and key to what might be going on both in your patient’s mind and between you. Are you a rivaled object? Is having the same lover a way of having access to you? Might your patient unconsciously be setting up just such a rivalrous con - text to see who “wins”? You haven’t said anything about what the issues are in the treatment, but this potential enactment is rife with themes of wishing: competition, longing, triumph, a powerful site of projection. To stay open to all of this, to use it analytically, is your aim.
In your personal life, I would also suggest that you try to pay attention to where and how your patient is in your mind: what pressures might be exerted, what the nature of your own fantasy is, how your patient appears even when you aren’t in the office working.
Good luck with this—it sounds demanding but also potentially really interesting and fruitful.
With all best wishes,
Dr. Lina Donato
Dear both,
First of all—thank you. I breathed a sigh of relief more than once while reading both of these responses. I wrote to you about this dilemma from my desk at home, in my private space and in my free time, from which this seemed an unbearably messy situation. But you each, collegially, nudged my attention back to the space of analysis—the space at issue here. Thank you for that.
I restarted supervision a couple of weeks before reading your replies. It had been too long since I had been supervised, and I can already feel that it will be helpful in ways that go beyond this particular issue.
At my most freaked out, I had started to worry that my patient knew we shared a sexual partner—that my own connection to this third party might even have been part of her attraction. These things may turn out to be the case, but I am trying to reinhabit a position from which I project less and hopefully hear more.
This whole situation—the fears of boundarylessness, pangs of jealousy, vague sense of professional foreboding— has lit a fire under my personal analysis in fruitful and oh-so-difficult ways. I thought I was on the other side of a lot of content that I’m back in the middle of! The sexual partner in question cooled things off with me before I was able to make a decision about whether I would be comfortable continuing things with her. Relief and hurt ensued. Therapy and supervision ensued. And so on.
Thank you both for dedramatizing what felt like a catastrophe; I was able to see that the catastrophizing was material for my own analysis. Thank you also for reminding me of the resources available to me. And, finally, thank you for the reminder of the singularity of the analytic space as a place for the analysand’s “subjective agency.” At a certain point, reading and rereading your replies, I started to remember that my own guilt, self-judgment, and insecurity are very relevant to me, but just not that relevant to the case at hand.
With gratitude,
“Help!”