ABSTRACT
First impressions: I am pleased that Dr. Samstag chose to present his work with such a challenging patient. The case clearly demonstrates his ability to engage with a patient who has great difficulty in relating to any other person. I also believe that it clearly demonstrates how interpersonal psychoanalytic treatment can be very powerful in helping patients who have such interpersonal difficulties. I believe that no other form of treatment would have been as effective. To present such long-term work, it is essential to present the analytic work in specific segments, or “eras,” of the treatment. I do wish, however, that Dr. Samstag had presented more material on the transitions between these “eras.” The use of dreams with an unrelated patient is essential and I was glad to see the amount of dream material presented in the case. I have certain differences in what I would have focused on in the work with some of the material, but overall there was a productive use of the dreams. The patient showed enormous progress in his ability to relate to others, which was the most important change in his life. I do wonder about the lack of progress in his professional life and if more analytic work could have been focused on this aspect. Was it not addressed because of the father’s financing the treatment and therefore was there a hesitancy in both patient and analyst about examining this issue in more depth?
