ABSTRACT
At noon, a young woman phones me, introduces herself, and starts crying. She says that she was referred to me because a terrible thing has happened. She does not know what to do. “I am probably either a horrible person or crazy. Tell me I’m not to blame. Please, tell me that it’s not my fault.” She breathes quickly and adds, “Even if you told me it wasn’t because of me, I’m not sure I’d believe you. I feel crazy. I don’t know what to do.” Karen tells me that she had been in therapy with Dr. A for six months when it all began. He took a month-long vacation, and that is when everything started imploding. When we first talk, she is preoccupied with the object’s death, her destructive power, and wordless breakdown. Using words as an enactment, this chapter will explore fantasies related to the destructive power of need, including the fantasy of weaning from the object as from drugs, food, or alcohol, the confusion between love and hate, murder and abandonment, and this confusion as expressed in the therapeutic dyad. The chapter concludes with the patient’s response to this story.
