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Response to “Thinking About Our Work: When the Therapist Becomes Ill” Joyce Slochower1 issn 0362-4021 © 2017 Eastern Group Psychotherapy Society group, Vol. 41, No. 4, Winter 2017 345 1 Professor Emerita of Psychology, Hunter College and the Graduate Center, City University of New York; Faculty, New York University Postdoctoral Program, Steven Mitchell Center, National Training Program of the National Institute for the Psychotherapies, Philadelphia Center for Relational Studies, Psychoanalytic Institute of Northern California; and private practice, New York. Correspondence should be addressed to Joyce Slochower, PhD, 15 West 75th Street, #8B, New York, NY 10023. E-mail: joyce.slochower@gmail.com. We therapists are more human than otherwise. OK, we try not to be. We try to be wiser, more emotionally even, more caring, decent, thoughtful, and mature than we are in our outside lives. (I think some of our patients know this, but others do not.) I’m a relational psychoanalyst; I believe far less than Alice in the clinical value of analyst-as-blank-screen. I use myself—my subjectivity, and sometimes aspects of my personal life—in the work, even though I’ve written a lot about holding and its therapeutic functions. But despite my belief in the mutative potential inherent in carefully chosen self-disclosure, I try to use those self-disclosures primarily in an effort to help the patient, not because I need to. After all, therapy space is protected space—it’s the patient’s space. But I also easily enter Alice’s experience. When physical (and sometimes psychological ) agony and trauma break into our therapeutic identity, we are rendered vulnerable, helpless, unable to set ourselves aside. We lose access to our therapist self-state. We’re unable to think about the patient in a sustained way. We suddenly cannot work with our subjectivity or set it aside. Alice’s acute illness left her in that kind of state. She was precipitated out of the ordinary, out of a bounded, careful therapeutic position and into one that utterly disrupted her own sense of the treatment frame. Uncannily, I had a similar, though less serious, experience two months ago: In a freak accident, I fell and (though I didn’t realize it until later) fractured my kneecap. Despite being in considerable pain, 346 slochower my need to hold on to a sense of intactness left me in a state of shock and denial for some hours. I continued business as usual; I iced my knee and then saw some patients. I was going away the next day and had already checked in for my flight. I told my friend we were going. Then pain broke through my manic defense, and I was forced to acknowledge that I was not OK, could not go away, and needed to go see a doctor. I sent my study group home midway through the meeting and went to urgent care. Still holding on to to denial, I told them that I was sure the X-ray would be negative but wanted to rule out a fracture. I phoned my patients and canceled that day, telling them what had happened. I saw people again the following day, but I was hobbling in a straight leg brace, unable to sit down or walk comfortably; my leg was an elephant in the room. In fact, it’s only now that my patients can ignore it. Like Alice, I had no choice but to tell. There’s a difference between deliberate, judicious self-disclosure and the sort that’s foisted upon us when life disrupts our going-on-being and renders us, in an instant, utterly helpless and vulnerable. ...