ABSTRACT
It must be assumed, of course, that her General Practitioner, who referred her, has taken all reasonable steps to exclude organic illness. This being so, anyone trained in psychotherapy would have no difficulty in making a preliminary hypothesis: she has suffered a severe trauma, which has involved both the loss of people who have virtually been her parents since she was born, and a transfer to people who, though her real parents in fact, were total strangers with whom she clearly did not get on. We all know by now the kinds of unbearable feeling of loss, deprivation, and anger which such an event is likely to have aroused in her and might well be expressed in a symptom; and this interpretation is confirmed by the information that her symptom in fact dates
from that time. We have thus already made a psychodynamic formulation. Obviously, the correct treatment is psychotherapy in depth, with the aim of bringing out the feelings and resolving them.
