Dear Peggy,
Your observation about the scolding, even contemptuous tone of Jennifer’s confrontation of Tony brings to mind a familiar problem with patients who have “vertical splits” (separate facets of the personality that remain unintegrated) like Tony. Often there is a corresponding countertransference that “fits” with each of the different sectors of the patient’s psyche. So if Tony shows his anti-social colors, Jennifer will become belligerent, nasty, and sadistic in response. If he is more psychological and shows his capacity for concern, she is likely to become softer and gentler with him. For all the difficulties she has had with him, I think she has done a fairly creditable job. She recognized her error in accepting overpayment last month and is not billing him this month to rectify that mistake. Her interpretive strategy is getting through to Tony (finally). And as you suggest, Peggy, her enactment of this transference-countertransference scenario may be necessary to reach her patient in a way that will make a difference.
Glen
