Today I spoke with Dr. Dhwani Shah about his new book The Analyst’s Torment: Unbearable Mental States in Countertransference (Karnac Books, 2022). The son of a sculptor mother and an internist father Shah has always been interested in subjectivity, aesthetics, art, and “how to find objectivity in subjectivity.” He began his practice with the fantasy that “I could understand things, I would know things and then I would be able to treat my patients, heal them, heal myself.” However, when his two-year-old son became (and remains) non-verbal and got the diagnosis of autism these fantasies were “dismantled”. This changed his “attitude about this search for knowledge” and evolved into different way of being with patients and learning how to “painfully accept emotional truth.”
Shah’s torments are broken into 8 chapters aimed at helping us understand “what really gets in our way of us really being able to be with our patients.” 

Arrogance: the manner in which we can arrogantly transform people into cartoon characters for our arrogant purposes.

Racism: if you do not come across any racist or prejudiced parts of yourself or your patients, you have not been paying close enough attention. 

Dread: which signals an unbearable emotional truth.

Erotic Dread: of our own erotic desire to work with patients.

Dissociation: as a process or a structure. 

Shame: How shame lies uncomfortably close to the core of psychoanalysis.

Hopelessness: undermines the inherent vitality and exploration in the analytic space. 

Jealousy: In analysis we are all excluded from paradise.


Shah hopes that the structure of these chapters will give us ways to talk “about the struggle of what to do with our feelings”. The interview ends with a question familiar to all clinicians: Since these unbearable mental states are unavoidable and ubiquitous in analytic practice, why would anyone do it? “Because” Shah answers, “eventually we break apart, and we’re left with the beauty of the work and a shift from an epistemological way of knowing to a way of being.
Christopher Russell, LP is a psychoanalyst in Chelsea, Manhattan. He is a member of the faculty and supervising analyst at The Center for Modern Psychoanalytic Studies and The New York Graduate School of Psychoanalysis. His primary theorists are Sándor Ferenczi and Hyman Spotnitz.
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