Identification with the Schizophrenic Superego

Carolyn, to whom I have referred in previous papers, was extraordinarily resistant. The work was going very slowly. People in our field often tell us how important it is to have a therapeutic alliance. Indeed, I have often read in work by well-known authors that, without a therapeutic alliance, therapy cannot be done. To Carolyn, that concept was as foreign as snow in July. For at least half the time, therapeutic war would have been a more apt description. Without exaggeration, I can safely say that in the nine years I have been treating her, she has threatened to leave at least 100 or 150 times. In earlier times, at least once a month, she would not appear for a session for which she knew she would have to pay. Any session, in which I was more than usually insightful would be followed by a session that was mostly spent with her attempts to manipulate me, trick me, ignore me, lie to me and resist in any way, she could. In effect, no good deed of mine went unpunished. On November 1997, the following interchange took place: I

Are you frightened of being alone?

C

Yes, it’s creepy being alone. It’s like being in another world.

I

Who are you without?

C

My mother and my guilt. Yes, I’m without my mother but I’d like being alone if I were my mother.

I

(startled) If you are your mother, then where is Carolyn? (At this point I have the insight that she is literally identified with her mother and she is not Carolyn when she is hostile.)

C

Then I am her. I hate her. I don’t want to be her. I could let her go, if I knew where to put her (looking genuinely puzzled as to where, literally, to put her mother). What do I say? If I was her, she’d love me. Same thing with Johnny 168(her dead brother about whom she has obsessed for 18 years when she first came to see me.) I’d keep him alive.

I

You’re Johnny too?

C

I’m not Johnny. He is too hard to be.