In a message dated 97-10-31 04:24:13 EST, Jaime Goldchain wrote:

<< Dear David:

       ...This person brings herself as she is, with that "symptom". I think
that
 there is no reason, in this case, to ask not to present the symptom. Is
 like to ask somebody who is afraid of hights to go to the Empire State
 building.>>

Yes, this was exactly a part of my dilemma with her.  She needed to repeat
her symptom as part of the early therapy relationship, and I didn't want to
discourage that.  And yet, to go along with her symptom would have meant to
possibly act out with my other patient--her friend--by accepting a referral
from her, when ideally referrals from current patients ought to be explored
versus acted-upon, at least initially.  I realize there may be some
disagreement about this.

<<...The point is not who is the referral, you donīt need that information. I
think one can "work" without knowing this...>

I would agree, in general, but it seems different to me when the referral
source is a current patient, and a friend of the person who was referred.

<<... After all, what it should matter to us is the transference. You are
absolutly right that this affect the tratment, of course, everything affects
it. The particularity here is this "secret" consitutes an inhibition, and
that patient has to deal and work with it...>>

Yes--and I would have taken just this position myself had she been referred
from another source.

Thanks for your input!

Regards,

David M.