Gianni Nebiosi's richly evocative clinical presentation, which he dedicated to Emanuel Ghent, describes his analytic work with Tano. This young man comes to analysis because of intense anxiety, and because his love and sex life is a mess. The narrative focuses on an impasse and resolution in the analysis. The analysis gets off to a quick start. Tano was born in a small town in Italy. When he was one, his parents moved to Naples where they worked as university professors. They left him in the care of his grandparents, with the explanation that they couldn't take proper care of him. When he was 11, his parents moved back and he went to live with them.

The beginning of the analysis is collaborative and playful. Following a session that involves a humorous and mutually affectionate interchange, Tano brings in a secret: while doing homework in his father's study, he was terribly upset to find a pornographic magazine. Gianni's sensitive interpretation of Tano's need for intimacy with his distant father spurs Tano's recollections of how sweet small town life had been with his grandmother.

During the first three years, the main topic of the analysis is Tano's impossible love life. He pursues girls who he is sure have a crush on him, and is repeatedly rejected. The impasse begins when Gianni suggests they explore why Tano feels the girls are in love with him. Tano reacts angrily and the analytic atmosphere gradually changes. He becomes openly hostile, and feels that Gianni is trying to push him to "kill his childhood." Gianni, feeling frustrated and paralyzed, asks why Tano is so angry whenever he tries to help him in his relationships with women. Tano's furious reply is that he wants to keep his desperate feelings, and "you instead want to repair my desperation, which is the only thing I have that is truly mine." Tano's angry insistence on his desperate feelings catches Gianni completely off-guard. He finds it hard to understand Tano's need to cling to his desperation. It becomes harder to feel close to Tano, and Gianni begins to feel that they are drifting farther and farther apart.

Gianni explained his approach to resolving an impasse: the analyst can benefit from deconstructing the part of his own subjectivity that is at odds with the patient's subjectivity. Gianni searches his own history and recalls a memory from his childhood, when his family seemed unaffected by the death of his beloved dog, and he held onto his upset in order to have the emotional importance of the pet recognized. From his altered emotional perspective, Gianni can become available to Tano, and he facilitates Tano's exploration of his painful memories and their traumatic meanings. Mutual empathic understanding is restored, and this becomes the turning point in the analysis.

In his discussion of Gianni Nebiosi's paper, Alan Kindler describes the beginning of Tano's analysis, when Gianni and Tano interacted imaginatively and confidently. Kindler sees Tano's description of the psychoanalytic experience, "Psychoanalysis sure is strange. Memories hurt, but then your memory is better," as the emergence of an expanded self-awareness and self-narrative in the presence of another who understands and articulates his experience. The impasse begins when Gianni attempts to explore the reasons why he feels so sure that those girls are in love with him. Kindler, using a classical Self Psychological perspective, believes that Tano experiences Gianni's comments as shaming criticisms of his relationships with women. The mirroring selfobject transference is disrupted by this intervention. They are now enacting the traumatic past in which Tano's parents were oblivious to the pain they caused him in their pursuit of their own careers. Tano is in a state of fragmentation, with his sense of self organized around his anger. Kindler reviews this impasse from various modern Self Psychological viewpoints. He cites Atwood and Stolorow, who propose that impasses evolve because the discordant organizing principles of each participant remain invariant. They are not able to understand each other and unable to think about why this is so; the analyst loses his capacity for self-reflection. Kindler recounts Gianni's moving description of his efforts to recover his empathic understanding of Tano, and identifies the resolution of this impasse as an example of Atwood and Stolorow's principle that impasses can be a "royal road" to psychoanalytic understanding when the analyst becomes free to reflect on his own organizing principles rather than just be them. Kindler summarizes the lessons to be learned from Gianni's sensitive illustration of an impasse and resolution: the importance of the analyst's analysis in strengthening his self-reflective powers (Doctors), the ongoing importance of idealizable teachers and colleagues, the essential value of empathic understanding in creating the possibility of psychoanalytic change, and most notably the requirement that the analyst be prepared to undergo personal change in the course of each analysis.

Margaret Black privileges the centrality and complexity of communications between patient and analyst as the core of psychoanalysis. She emphasizes that the shared experience between patient and analyst can function as a crucible within which undeveloped aspects of the patient's self become available. Within this context, she defines impasse as the subjective experience of the analyst when she/he is no longer able to process the communication within the analytic dyad. The analyst's awareness of shifting identifications with the patient's cast of internal characters vanishes, replaced by the sense of being caught in a role that feels all too real. She examines Gianni's clinical material through this lens.

Black differentiates her thinking from Gianni's idea that when faced with an impasse, the analyst needs to deconstruct the part of his subjectivity which is at odds with the patient. Black does not view impasse as having a single explanation. Her perception is that an impasse often reveals itself as an enactment, a complex analytic communication in which patient and analyst unwittingly participate in representing some aspect of the patient's inner experience in the interaction. Representations of problematic experience from the past are often confusingly entangled with potentially healing experience embedded within the present analytic relationship. Black approaches an impasse by trying to determine what role she is unconsciously playing with her patient.

She observes that in the beginning of the analysis, Tano is stuck in his pattern of attaching himself to "independent" women. He gives little expression of initiative or male assertiveness. Black focuses on the change in Gianni's approach three years into the analysis. Frustrated that his repeated attempts at affective resonance produce no change, he begins to challenge Tano, suggesting they explore why Tano was so sure that those girls were in love with him. Black observes that Gianni's abrupt shift from an approach of emotional resonance to one that is authoritative and interpretive seems uncharacteristic of his work. When a treatment that initially goes well grinds down into a stalemate, Black suspects that the kind of involvement offered has taken on new meaning for the patient. She speculates that Gianni's warm emotional resonance tapped into Tano's relationship with his warm and caring grandmother. But the warm in-tuneness of the analytic relationship might also be seen as a signal to inhibit his own assertiveness, a price he may have paid to keep his relationship with his grandmother feeling secure. She hypothesizes that Gianni's challenging intervention may have surfaced as an enactment related to Tano's difficulty engaging and experiencing his own energy. Black's premise is that this intervention signals to Tano that Gianni could take off the gloves with him, and serves as an invitation to Tano's own assertive, aggressive aspects. In this analytic process, much of the communication is not explicit. She contends that sometimes our patients push us into roles and experiences that have been missing in their lives. Perhaps Tano felt that it was his parents' lack of worry - their self-justifying conclusion that their problem was fixed once he was living with his grandparents - that made their emotional disconnection from him possible. Where Gianni describes the resolution of the impasse as a renewal of their affective connection, Black sees him as doing much more - creating a new relational experience that allows Tano to grow in his presence.