Psychoanalysis, Culture & Society

, Volume 23, Issue 4, pp 419–436 | Cite as

Loss, self-states, and the immigrant analyst: Exploring the “analytic fourth”

  • Gurmeet S. KanwalEmail author
Original Article


In this paper I explore how immigration impacts the experience of working as a psychoanalyst. I describe a kind of loss that can be experienced between an immigrant analyst or therapist, and certain patients. What is lost to the analyst, and what is lost on the patient? What is mourned, and what is not? I suggest that the loss has something to do with the inactivation, withdrawal, or extinction of certain self-state experiences. I use the term “analytic fourth” to refer to these relational self-states that fail to become consummated between patient and therapist.


culture immigration loss psychoanalysis psychotherapy self-states 



I am grateful to my patients without whom this understanding of my experience would not be possible. Thanks also to Richard Chefetz (personal communication) for pointing to the importance of language in making it hard for culturally displaced individuals to mourn, because of difficulty with symbolizing feelings. For reasons of lack of space, I have alluded only marginally to the role of language in this paper.


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Copyright information

© Macmillan Publishers Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.New YorkUSA
  2. 2.William Alanson White Institute of Psychiatry, Psychoanalysis and PsychologyNew YorkUSA
  3. 3.Weill Medical College of Cornell UniversityNew YorkUSA

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