Ellen Pinsky, "Death and Fallibility in the Psychoanalytic Encounter: Mortal Gifts" (Routledge, 2017)

If I could vote for my favorite new psychoanalytic book of the 21st century, Ellen Pinsky's Death and Fallibility in the Psychoanalytic Encounter: Mortal Gifts (Routledge, 2017) would be it.

But to be clear, this is actually a set of essays and definitely not a collection of articles: it is full of style. The author marries two blind spots in the field and creates a conversation between them. The result of this union yields a reflective rejoinder to popular psychoanalytic preoccupations old and new, chief among them, enactments, neutrality, analytic subjectivity, and abstinence.

These essays also return sex and death to the heart of the psychoanalytic endeavor while reminding the reader that technique and ethics are one and the same.

Pinsky sets out to explore the field’s overall silence regarding the mortality of the analyst and his sexual transgressions in the consulting room.  She asks, what happens to the patient when the analysis is brought to a sudden end, by death or violation of the frame?

She argues that the turning of a blind eye to these two conceptually interrelated “events” is rooted in a deeper refusal to wrestle with the demands of analytic work and the analyst's fallibility.  (I could make an argument that this is also largely a book about men in the field but that would be a separate essay.)

Our consulting rooms are, ideally, transference hothouses.  How can the analyst survive the rigors of a setting that demands he listen, feel and absorb multiple transferences, and perhaps most especially the demand for love and gratification, without acting?  What, if any, possible preparation can safeguard analysts and analytic treatments from demise?  How does the analyst endure not mattering day in and day out, because if we are honest, we know the transference is not about who we actually are? Have we fallen prey to a narrative that sees the analyst as being like a God, beyond death, asks Pinsky, so as to protect the analyst from the truth of his human imperfectability, and to compensate for his deprivations?

If we are abstinent, she argues, desire grows, and if we are neutral, the patient wants to say more.  Desire and freedom flourish in this fertile surround.  Should the transference flower, and wildly so, on the uptick, ghosts become ancestors. However, should the analyst feel indomitable, beyond supervision, (an American conceit for sure) he can lose the proverbial thread, thinking of himself as an exception, beyond death or analytic responsibility.  He may believe the love emanating from the patient to be about his person and feel compelled to act or, he is driven to retaliate because he knows he is irrelevant yet must suffer verbal slings and arrows.  Either which, the patient, giving the analyst her all, may concomitantly find her wishes for love gratified, yet her analysis annihilated.

Perhaps it would be better if her analyst had died without a warning? And many an analyst dies without giving any warning, leaving patients scattered hither and yon.  How, asks Pinsky, do we tell a patient that things must come to an unwelcome end?  What does the patient lose when the analyst dies anyway?  What is the fate of the transference when the conditions that house it are destroyed, either by death or transgression?

Tracy Morgan is the founding editor of New Books in Psychoanalysis and a psychoanalyst, working in NY, NY and Rome, Italy.  She can be reached at tracedoris@gmail.com.

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