The Impact of the Analyst's Existential Exposure: Commentary on Paper by Stuart A. Pizer.

The concept of existential exposure speaks to those encounters in which our generally successful efforts to avoid the full knowledge of our human condition utterly fail us. Despite our denial and the usually reliable dissociative mechanisms we use to support it, the truth of our unprotected, vulnerable state becomes psychically real. I make use of Pizer's narrative about his medical crisis and its impact on his analytic self states to explore how body/mind alterations that constituted his experience of existential exposure affected his analytic subjectivity and the evolving intersubjectivity with his patient. I suggest that the experience of existential exposure is registered through the body, which is the medium through which disembodied abstractions about existence are made real. Dysregulation in the body creates a powerful psychic disequilibrium marked by the loss of omnipotence and control. When they are not so overwhelming as to produce trauma, these destabilizing experiences can foster the emergence of new self states that reflect greater flexibility, elasticity, and freedom in one's sense of self. I underscore the complex intersubjective impact of the analyst's embodied experience of existential exposure: how it shifted the transference/countertransference by introducing an “existential Third” into the treatment, leveled the playing field between patient and analyst, and may have served not only to expand but also to constrict aspects of the analyst's subjectivity. [ABSTRACT FROM AUTHOR]