ABSTRACT
This chapter introduces the four clinical cases described in Part II.
During the course of their therapy, all four patients manifested signs that are usually found in infantile autism, namely: difficulties in establishing affective relationships, adhesive attachment to the analyst mixed with mistrust and persecutory ideation, obsessive fixation on specific themes and a deficit in the process of symbolization. These cases differ in the manifestation of the symptoms, the level of social and cultural integration, and the variety of defence mechanisms constructed over time.
The theme of the mask is explored here in relation to the clinical cases described. Regarding identity, Groddeck highlights that the word ‘I’ does not represent one’s true identity, but is an assemblage of characteristics exposed to the public, which may hide the true Self. During the course of a lifetime, we all choose various masks – so much so that we may end up not knowing our truth any more, thus experiencing a level of suffering that can be very difficult to express.
The author discusses two of the biggest challenges encountered during this work: the difficulty in establishing emotional contact through which an alliance could be established; and the great mental vacuum projected by the patient onto the analyst.
