We are in complete agreement. People rarely come to us seeking enlightenment; that is one of our subspecialties but not the main reason we were licenced. I think that this case illustrates perfectly the requirement that we be sensitive to the needs of the patient. Not to say that treatment should be cut and dried, manufactured to fit only those complaints about which the patient is aware. Another part of our job is the responsibility to provide road maps for the territory the patient may traverse in the future (realms not presently accessible because of the limitations placed on that individual by their history) so that when the "new" experience occurs, they have "been there already" to some extent.
I was really put off by the classical psychoanalysts who ran my residency when they claimed that there was such a thing as "termination" after which the two people would never work together again. The relationship built between therapist and patient is mostly real and only partly transferential; the real must not be sacrificed for the theoretical benefit of a "completely analyzed transference." Thus it is important for the patient to know that they may return to see us any time and for any reason. This theoretical position allows me to accept less than "perfect" results in the short run, to avoid shaming those who leave "early," and to participate in the growth of people for the rest of our mutual lives. It doesn't take much training to tell the difference between a mature relationship and failure to master the skills involved in the toddler's efforts to depend less on the caregiver!
Finally, I think one ought to ask Otto whether his life is joyless. He might disagree wholeheartedly, experiencing pride in his business relationships and successes, excitement in the chase, and joy when he can reap the rewards of business success by acting as the American representative to Austria as in the opening sentences of the case presentation. How many of us have had this pleasure? Is it not our own transference that leads us to view with displeasure what he calls success?