ABSTRACT
The chapter describes the development of an exceptional, long-term clinical case with which the author was involved from three different perspectives in succession: evaluation, supervision, and analytic treatment.
From the clinical viewpoint, the case illustrates two levels of analysis: the perspective of psychoanalytic developmental psychopathology; and the development of an analytic process with an unusual approach over a long period of time in different clinical settings.
Three concepts are central in the management and outcomes of the case: continuity of being: there is a vital need for a facilitating environment in which the presence of the mother (or caregiver or analyst) is able to ensure the infant's or patient's unity of being, and to facilitate the developmental processes of integration. Being there (in infancy or in analysis) can be even more important than the ability to offer technically adequate care; cumulative trauma, a revolutionary concept introduced by Khan (1963); transformations (Bion, Bollas).
The case material demonstrates how adolescence is certainly the key phase where early negative experiences can be overcome, but it is also the central factor of psychopathological risk.
