This paper is based on a talk given at the conference to celebrate the Work of Hanna Segal and attempts to summarise her contribution to psychoanalysis. I suggest that in addition to being the important presenter of the work of Melanie Klein, she made major contributions to our understanding of many analytic ideas, for example, symbol formation, the usefulness of the concept of the death instinct and the relation between phantasy and reality. She was a pioneer in the analytic treatment of psychosis and sh wrote important papers on literature and aesthetics. She was a great teacher and emphasised the central role played by the analytic setting in representing the attitude of the analyst.

The author elaborates on Bion's (1961) description of "the numbing feeling of reality," to which the analyst may become susceptible in certain clinical situations; that is, the analyst may become preoccupied with the patient's reality and, under pressure of his morality, can become numbed to an awareness of the psychic reality of the transference. In particular, this involves a propensity by both patient and analyst to deny the reality of loss through deployment of omnipotent fantasy. When this is recognized by the analyst, he can adopt more limited and realistic goals, and omnipotence may gradually be relinquished and mourned. Illustrative clinical material is provided.

(2011). The Impostor Revisited. The Psychoanalytic Quarterly: Vol. 80, No. 4, pp. 1061-1071.

This paper describes a clinical situation in which the analyst may be provoked to become overactive if he feels that his attempts to reach his patient are frustrated. Lack of tolerance for feelings of helplessness may leave him unable to sustain a receptive stance, and he may be drawn into enactments which lead to a power struggle with his patient.I will try to describe situations where such enactments were compelling. I will also consider what enabled me to extricate myself from the activity, at least intermittently, to re-establish an analytic attitude in which understanding and containment were priorities.From time to time I was able to recognize and accept my helplessness and relinquish my attempts to reach the patient. These moments of recognition led to a shift of atmosphere in which a feeling of sadness replaced the more familiar confrontational mood. In these sadder moods the patient felt I was more available, and he too seemed more able to contemplate loss.Theoretical ideas that enabled me to recognize some of the mechanisms at play included an understanding of narcissistic mechanisms, a recognition of previous ideas of power and dominance such as Freud's Bemachtigungstrieb, and the role of dominance in the resolution of the Oedipus complex. My previous work on the dread of humiliation allowed me to be sensitive to the way helplessness can come to be associated with being looked down on and humiliated.

Résumé Dans cet article, l’auteur passe brièvement en revue les principaux points concernant le développement des idées sur le transfert, idées tributaires des découvertes de Freud. Quelques développements prenant leur origine dans l’œuvre de Freud seront ainsi discutés à partir de la forte impression qu’ils ont laissée. L’auteur mentionne en particulier l’élaboration chez Melanie Klein d’un monde interne peuplé d’objets internes et sa description des mécanismes du clivage et de l’identification projective, ayant tous deux profondément modifié notre compréhension du transfert. En partant d’un matériel clinique particulier, l’auteur illustre une situation transférentielle de grande importance et, selon lui, mésestimée, malgré son rapport à la « situation totale » telle qu’envisagée par Klein. Dans ce type de transfert, l’analyste se retrouve en position d’observer et, dès lors, n’est plus l’objet primaire à qui s’adressent l’amour autant que la haine. Il est au contraire placé en position de figure exclue et il peut aisément être poussé à agir plutôt qu’à comprendre le rôle qui lui est attribué. Dans cette situation, il peut tendre à rétablir la position d’objet primaire dans le transfert du patient ou, inversement, éviter la dimension transférentielle en faisant des interprétations extra-transférentielles et se mettre alors à agir le rôle d’un surmoi jugeant et critique. S’il peut tolérer la perte d’un rôle central et comprendre la position transférentielle dans laquelle il est placé à certains moments, l’analyste parviendra à réduire la tendance à agir, et faire émerger des sentiments en rapport avec le deuil et la perte présents en lui et chez le patient.

In this paper I briefly review some significant points in the development of ideas on transference which owe so much to the discoveries of Freud. I then discuss some of the subsequent developments which were based on Freud 's work and which have personally impressed me. In particular I mention Melanie Klein's elaboration of an internal world peopled by internal object and her description of the mechanisms of splitting and projective identification, both of which profoundly affect our understanding of transference. Using some clinical material I try to illustrate an important transference situation which I do not think has been sufficiently emphasized although it is part of the 'total situation' outlined by Klein. In this kind of transference the analyst finds himself in an observing position and is no longer the primary object to whom love and hate are directed. Instead he is put in a position of an excluded figure who can easily enact rather than understand the role he has been put in. In this situation he may try to regain the position as the patient's primary object in the transference or avoid the transference altogether and make extra-transference interpretations and in this way enact the role of a judgemental and critical super-ego. If he can tolerate the loss of a central role and understand the transference position he has been put in, the analyst can sometimes reduce enactments and release feelings to do with mourning and loss in both himself and his patient.

Seeing and being seen are important aspects of narcissism, where self-consciousness is always a feature, and one which becomes acute when a patient loses the protection of a narcissistic relationship and is obliged to tolerate a degree of separateness. Having felt hidden and protected, he now feels conspicuous and exposed to a gaze which makes him vulnerable to humiliation. This often has a devastating and unbearable quality to it, particularly when it is felt to arise in retaliation to the patient's own use of gaze to establish a superiority which allowed the patient to look down on others. The need to avoid or cut short such humiliation may be so acute that the patient cannot deal with guilt and other emotions connected with loss which might otherwise be bearable. The author argues that development is impeded unless the patient is able to gain support to make the humiliation better understood and hence better tolerated. He describes some sessions from an analysis to illustrate how, in some analytic situations, much of the patient's concern and many of his defensive manoeuvres aim to reduce or to reverse experiences of humiliation. An understanding of the mechanisms involved seemed to enable some development to proceed.

Conflict between facing the reality of loss on the one hand, and denying it on the other, is explored in clinical material drawn from an analysis approaching termination. The intrapsychic conflict over loss was expressed as a conflict between morality and reality, and was externalized as a conflict between patient and analyst. For the patient, giving up resentment toward the analyst became tantamount to giving up the ideal object and losing omnipotence. In the course of the analysis, his complaints became less convincing, and the conflict over loss became more conscious, allowing some moves toward mourning to take place.

Summary The changing aims of psychoanalysis are discussed with reference to Money-Kyrle's paper on the subject. The theory of dammed-up libido, the theory of moral conflict and the theory of misrepresentations and perversion of reality which he described, all imply different aims. It is argued that, in addition, the theory of projective identification leads to a radical change in the aim of treatment which can now be formulated in terms of helping the patient regain lost parts of the self.

SUMMARY In this paper I discuss what I consider to be the important elements in the training of a psychotherapist. In particular I have stressed those which form the basis of a psychoanalytic training and have tried to give some indications of the reasons for their importance. A personal analysis, abundant clinical experience with supervision and a study of theory are all considered to be essential. Some clinical material is used to illustrate these different components of training.