ABSTRACT
In this chapter, I discuss some of the difficulties that arose in the analysis of a seriously disturbed patient who found it very hard to talk about himself. He defended against awareness of conflicts, ideas, and affects while being tormented and often overwhelmed by them. He seemed to have acquired an inhibited character that was not, however, schizoid in the diagnostic sense. He related to others in a wary, quarrelsome, but passive way. It became apparent in the analysis that his sense of who he was was profoundly confused. Attention to archaic fantasies led to the emergence of a parthenogenetic unconscious fantasy involving identification with his mother and the attempted eradication of the mental function of his father. Experiences of differentiating himself from me in the analysis led to extreme anxiety, including a periodic risk of failure of ego functions with the arousal of latent psychotic anxieties. Interpretation of the content of sessions became possible only after several years; until then an understanding of his panic-filled need to prevent contact or change, and the motivation for this, predominated. Some confusing transference and countertransference experiences in the analysis are also described. Disclosure of what we came to call “unofficial” communications by the patient, expressed as lapses by his supervigilant superego, gradually revealed his crises and feelings. These idiosyncratic, muted appeals for help became a vehicle through which exploration of content, its transference meaning, and the beginnings of a new kind of relating became possible. The dependency feelings associated with a new form of relating and emotional growth brought varying degrees of mental pain. Eventually, this pain forced the patient, after 8 years of analysis, to leave out of a fear of decompensation.
