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Facing mortality while treating patients: a plea for a measure of authenticity.

This article revisits aspects of a life-threatening illness I endured over twenty years ago, reviews responses to my paper on this topic, and offers personal recommendations to currently sick analysts and to our analytic institutes and societies. It emphasizes the ineffable, undocumentable, non-verbal aspects of my work with psychotic patients, and the profound empathy I found in them, which seemed to exceed that of less disordered patients. They were not strangers to chronic terror. I became a fellow traveler. Paradoxically, I felt that they were not so encumbered with denial and avoidance of death as are more functional people. My teacher and friend, Jerome Frank (1961), in his classic text Persuasion and Healing discussed the universal features of psychotherapy. While he wrote about those members of a community designated as healers, I was impressed by my patients’ efforts to heal me, to act as my shamans or therapists. Frank says, “The success of a psychotherapist depends in part on his really caring about the patient’s welfare, and the odds are that he can invest more of himself, other things being equal, in patients he can like and respect, if not for what they are, then for what they can become” (p.130). Joan Halifax (1982), in her book Shamans: The Wounded Healer says, “I [will focus] on the inner journey shamans take during a life crisis and the ways in which they order the chaos and confusion of the voyage into Cosmos. The extraordinary consistency of the shamanic complex emerges in the study of this ordering process. That this commonality cuts across seemingly irreconcilable ethnic and cul