The term "blog" refers to a web-based journal wherein individuals offer up their personal experiences to anyone with a web browser. The editors at IMPULSE seek out local analytic candidates willing to "blog" their experience in training. Our guest blogger is finishing a residency in psychiatry and is a second year candidate at a psychoanalytic training institute. This piece, "Second Thoughts," examines the intricacies of selecting a control case.

At the end of the session, he sticks out his hand. I blink and pause for a moment. I think back.

"...I think I can help him," I remember telling my supervisor. "But I don't know if he would be a good analytic case. I don't know if he would be appropriate." I twitch nervously. 

I say this, but I already know the answer to my own question. Of course, he would be an excellent control case. He is intelligent, psychologically-minded, neurotic range, has a stable, decent job, and he is not planning on going anywhere in the near future.

So I wonder. What is all this hesitation?

My own analyst's voice now echoes in my mind: "We are talking about a very intimate and close relationship."

Bewildered, I am struck by the strength of the transference and countertransference already manifest in this only once-a-week therapy. I am his paralyzed father whom he idealizes so intensely. He sits in my chair and exhibits a castrating, starting and stopping staccato. For him to supersede his father would mean to suffer his same fate. So he remains supremely ineffectual both in therapy and in his outside life.

This I can see. It's like a burr. And I know I could remove it. I see the treatment path we would take. But as I look into his eyes, I hesitate.

What about the enactments? What about all those feelings? Will I allow myself the hate and rage and, perhaps most importantly and most terrifyingly, love?

What is this work we do, anyways? Why even charge a fee?

Without meaning to, I shake his hand. He smiles and exits the room, looking down timidly, and I am left with a feeling of marked anxiety.