Patient-analyst "withness": on analytic "presencing," passion, and compassion in states of breakdown, despair, and deadness.

This paper focuses on the analyst's "presencing" (being there) within the patient's experiential world and within the grip of the psychoanalytic process, and the ensuing deep patient-analyst interconnectedness, as a fundamental dimension of analytic work. It engenders new possibilities for extending the reach of psychoanalytic treatment to more disturbed patients. Here patient and analyst forge an emergent new entity of interconnectedness or "withness" that goes beyond the confines of their separate subjectivities and the simple summation of the two. Using a detailed clinical illustration of a difficult analysis with a severely fetishistic-masochistic patient, the author describes the kind of knowledge, experience, and powerful effects that come into being when the analyst interconnects psychically with the patient in living through the process, and that relate specifically to the analyst's compassion.