Mentalization and metaphor, acknowled gement and grief
In this chapter, I describe my analytic work with a man whose feelings had been chronically neglected in both childhood and adulthood. He adapted to this by diminishing and criticizing himself, along with a chronic feeling of being wronged, among other things. This mode, which some might call masochistic or depressive, was apparent in our interaction around fee arrangements and elsewhere, and my own sensitivities were evoked. Working this out was complex and at times strained. Generally, my interventions combined a mix of psychoanalytic styles with efforts to maintain a (more or less) disciplined responsiveness under the various pressures of the transference and countertransference. Eventually, increased reflective capacity, confidence in the possibilities for interpersonal recognition, and a greater sense of the separateness of other people developed, though fitfully and incompletely.