Irwin Hirsch, “Coasting in the Countertransference: Conflicts of Self-Interest between Analyst and Patient” (Routledge, 2008)

This interview should be of interest to both a professional and lay audience. What analysand has not wondered to herself whether she just represents a paycheck in her analyst’s world?And what analyst has not kept a patient in treatment long after the analysis was brought to completion due to financial concerns?

In his book Coasting in the Countertransference: Conflicts of Self-Interest between Analyst and Patient (Routledge, 2008), Dr. Hirsch explores how analysts can coast in a treatment, indulging patients and themselves via preferred modes of relating that leave the patient’s problems, usually thorny problems, untouched. As analysts who share interests with our patients–be it the Mets, the pork chop at The Little Owl, or Jonathan Franzen’s latest–we may find that we engage them in certain ways so as to keep other issues, such as their sadism, their capacity to demean, or their dependency needs, at bay. Our fears, as analysts, may prevent us from addressing pressing issues with our patients–and so we consciously coast away from, as the now-deceased group analyst Lou Ormont used to say, “the sound of the cannons.”

And as we ended our fifty-minute hour, Dr. Hirsch helped this interviewer realize that there was an aspect of the book that she did not want to attend to, namely the analyst’s own character structure. Dr. Hirsch raised my awareness of my own capacity to coast.I suppose that is why he wrote this fine book.

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