ABSTRACT
Sally, a very disturbed 30-year-old woman, is the second child and eldest daughter of a large Catholic family of eight children. The family lived in a council house in a small town in the Midlands. The parents' marriage was unhappy, and the father left to live in another countiy when the patient was 12. Sally's relationship with her mother seems to have been highly ambivalent: however, she made close relationships with several siblings. She survived well until adolescence, at which point her schoolwork disintegrated and paranoid ideation began to colonize her mind. By 21 she was convinced that when she masturbated, the whole of the town was watching her; subsequently, she believed she was being filmed. She suffered extreme persecutory guilt feelings, which seemed to be linked to her past sexual activity. After careful investigation, it became apparent (beyond reasonable doubt) that she had had an incestuous relationship with her father from the age of 11, before his departure. It seemed likely that several of the children had been sexually interfered with in one 16way or another. Sally felt that her mother had abandoned her and had handed her over to her father, and she hated her mother for it. These feelings may also have had their origin earlier in her life, when she was displaced by six siblings at close intervals. She felt her mother had forced her into the role of being a mother to her younger siblings, which had prompted her to turn to father for affection. She viewed him in many ways as a mother. At the same time, it seems that Sally's father also viewed Sally to some extent as a maternal figure, thus adding to the confusion. Her longing for intimacy with her mother drew her into relationships with women, not overtly sexual but sufficient to make her feel sometimes that she was homosexual. At other times, she was afraid that she was masculine in her orientation. This was expressed concretely in moments of psychotic dread that she was turning into a man—a fear that may have partly been the expression of a wish to be in her father's place in order to have possession of the mother for whom she longed. It was interesting to observe that, when the theme of her longing and despair in relation to her mother emerged openly during treatment, she became quite sane and coherent for the duration of the conversation about that theme.
