As a follow-up to my recent postings on Binswanger, Buber and others (in anthropological medicine), the following are some thoughts on the subject of love from a Freudian psychoanalyst who is affiliated with NYU and other psychoanalytic institutes in New York (his earlier book on narcissism is excellent). (Parenthetically, and to clarify, I believe Binswanger never treated Ellen West. He reconstructed her experience through archival records at the hospital in which she was treated.)

Sheldon Bach (2006), in his recent volume Getting From Here To There: Analytic Love, Analytic Process, reminds us of Freud’s view (expressed in a letter to Carl Jung and about a month later at a meeting of the Vienna Psychoanalytic Society) that psychoanalysis is a cure effected through love. Freud once told Max Eddington that the “secret of therapy is to cure through love.” (Grotjahn, 1967, p. 445). More recently, Larry Davidson (2003, Living Outside of Mental Illness: Qualitative Studies of Recovery in Schizophrenia. NY: New York University Press) reminded us of the importance for the psychotic individual to have the experience of giving and caring for another human being. Harold Searles and Herbert Rosenfeld believed that one of the sources of anxiety in paranoid schizophrenia was the fear of having a destructive impact on another person, especially in the context of a growing emotional closeness. Searles wrote of the profound love the person with schizophrenia has for her or his mother. Bach (2006) refers to his friend Irving Steingart’s viewpoint that an analyst must learn to understand and love the patient’s psychic reality.

Bach adds that the patient also comes, in fortunate circumstances, to understand and love the analyst’s psychic reality. He also notes the importance of having access to one’s hateful and loving feelings in order to maintain one’s narcissistic balance and mental health, which includes understanding and respecting the patient’s hate. Bach notes:

“...in my view, if...patients do in fact fall in love with their psychoanalyst, then they are very lucky indeed. For if they have truly fallen in love with their analyst, then their analyst is very likely to have fallen in love with them, and when this happens, then the world becomes enchanted again” (p. 134).

I would like to end this with the profound words of Martin Buber and Bakhtin:

“A soul is never sick alone, but always through a betweenness, a situation between it and another existing being. The psychotherapist who has passed through the crisis may now dare to touch on this.” (Buber)

"I am conscious of myself and become myself only by revealing myself to another, through another and with the help of another...Every internal experience ends up on the boundary. The very being of [woman] man (both internal and external) is a profound communication. To be means to communicate...to be means to be for the other; and through him [her] for oneself. Man has no internal sovereign territory: he [she] is all and always on the boundary." (Bakhtin)

Brian Koehler