chapter  Four
21 Pages

Evelyn’s PhD in Wellness—a Fairbairnian understanding of the therapeutic relationship with a woman with dissociative identity disorder

WithPaul Finnegan

In this chapter, the author presents clinical material from Dr Paul Finnegan's work with Evelyn, a patient with dissociative identity disorder (DID), to illustrate how an extended version of Fairbairn's model of endopsychic structure might be used. Evelyn's perspective on therapy was that she continued to need someone to help her deal with the difficulties she faced in her life—particularly marital difficulties. As therapy was concluding, and her life was drawing to an end, Evelyn reflected that in the process of therapy she had achieved her "PhD in Wellness" and took great pride in having done so. Martha originally appeared during Evelyn's latency period and was modelled on positive aspects of her experience of her mother, her grandmother, and a much-admired woman who was a neighbour. Martha's appearance followed upon the development of a "good enough" therapeutic relationship and she functioned to assist in the management of the analyst's relationship with Evelyn.