ABSTRACT
This chapter presents a case study of Rachel, who was a short, wan, twenty-year-old young woman with blonde hair over her face. Before coming to San Francisco, Rachel had been attending a prestigious university in the Midwest, but she had dropped out because she couldn’t handle her increasing anxiety and panic about meeting her own very high standards for academic performance. Dr. Steinman’s experience with the intensity of her voice and her dramatic suicidal urges and punitive cutting and burning, led him to the conclusion that the best that could be done was a gradual psychotherapy, slowly decreasing her antipsychotic medicines as Rachel gained control over the conflicted areas. Rachel was struggling with a deficit wherein she was absent the internal means by which to soothe or comfort herself or feel confident or proud of her own being in the world.
