ABSTRACT
My patient Laurent's psychoanalysis was successfully concluded after an often complicated, sometimes trying, but always stimulating ten-year labor. Although I focus on two interrelated themes in my report, namely his sexual impotence and mourning, I acknowledge that much remained unexplored in this treatment for reasons that should become evident from my descriptions of both the patient and the therapeutic process. Indeed, my conduct of this analysis, along with those clinical decisions I made both initially and at various junctures in our odyssey, requires elaboration, if not justification, in my view. At the very least, these clinical issues implicate the very nature of the therapeutic process I helped to establish. While it may be claimed that any analysis can achieve the status of an infinite regress, given the nature of the unconscious as revealed by dream interpretation (e.g., Freud, 1900, p. 283), it does appear to me that this analysis in particular invites a discussion about the desirable limits we might place on the application of the psychoanalytic method to “nonstructured” analysands. Such patients, in my view, should not be deprived of the opportunity for analytic intervention, which for so many of them may constitute their only hope; but neither should they be put in the position of being at risk from their regressive or impulsive proclivities. In the account I offer, then, is an implicit proposal — hardly unique I must admit (e.g., Kohut, 1977, pp. 24-25) — to achieve a more prudent yet effective middle ground in our estimation of the therapeutic requirements of these patients.
