Jules Bregman wrote:
>
> In a message dated 97-10-30 13:06:50 EST, Menachem Feder wrote:
>
> <<  From a dialectical perspective it occurs to me that the institution
>  of some self-disclosure at this point >>
>
> Menachem,
>
> Would you explain "from a dialectical perspective..."  What is that
> perspective and how does it relate to your point?
>
> Thanks.
>
> Jules Bregman

Dear Jules,
        To be honest, when first introducing "dialectical" into my response, I
was not fully aware of the degree to which I experienced Dr Mittleman's
dilemma as reflecting (what I consider to be) profound dialectical
issues. However, thanks to your query I have had a chance to further
formulate my thoughts on this matter.
        When referring to "dialectic" I was taking issue with the the struggle
I perceived Dr Mittleman to be experiencing regarding the
object-relational stance, and ultimately the
interpretative/action-oriented stance he should adopt as therapist in
this initial encounter with his client.
        It appears that, among the competing role-demands therapists experience
with all patients at all stages in therapy, and which ultimately they
seek to identify, highlight, understand, and finally present back to the
patient as a focus of confronting the patient's own inner, split and
polarized, role demands/object relations, those presented at the initial
therapeutic encounter often revolve around issues of establishing a
therapeutic alliance (eg, intimacy, therapist role as protective
benevolent parent) on the one hand, while on the other hand having to
deal with "reality" issues of the therapist-patient relationship (eg,
some rules and expectations, setting limits, parental role of "neutral"
agent of reality).
        Thus, already at the outset the therapist is presented with an
opportunity to experience a significant dialectic struggle between two
opposite poles. However, the critical issue is the degree to which these
struggles resonate or at least touch upon dialectical pulls the patient
is experiencing, thus providing an opportunity to confront the inner
dialectics of the patient.
        In this case, the otherwise commonly experienced dialectic of the
first-session encounter was amplified by a unique circumstance presented
by the patient's connection to a former client, and her (and his)
discomfort with this - thus adding to the therapist's dialectical
stresses, and reflecting, perhaps, also a concurrent intense dilemma in
the patient ("the need to take care of herself VS the need to go to
great lengths to satisfy others, even at her own great expense").
        In terms of ultimate action and intervention on the part of Dr
Mittleman in this case, he is thus presented with a complex set of
considerations:
        Should he relate to/reflect upon/highlight the dialectical aspects of
his dilemma as a path linking to her dialectical dilemma? Should he
refrain from any interpretations completely at this early stage of
encounter, or at least from interpretations relating to dialectical
phenomena and experiences?
        However, it was the ultimate choice of this therapist to de-amplify the
dialectical aspects of the situation in favor of presenting boundaries
(ie, reality considerations) - ultimately favoring one side of a
dialectic.Thus, from this perspective, it would appear that Dr Mittleman
was drawing from his clinical experience to guage issues of timing and
intensity of interpretations.
        Personally, it appears to me that assuming that dialectics are what the
therapist was experiencing, and furthermore assuming that he was thus
empathically resonating with intense dialectics the patient was
struggling with, this kind of "interpretation" would have been more
experience-close for the patient, and, perhaps, also link-up with an
important growth need within the patient - perhaps allowing for fruitful
work together.

Menachem M Feder