A case history: from traumatic repetition towards psychic representability.Int J Psychoanal. 2008 Jun; 89(3):541-60.IJ
This paper is devoted principally to a case history concerning an analytic process extending over a period of almost ten years. The patient is B, who consulted the author after a traumatic episode. Although that was her reason for commencing treatment, a history of previous traumatogenic situations, including a rape during her adolescence, subsequently came to light. The author describes three stages of the treatment, reflected in three different settings in accordance with the work done by both patient and analyst in enabling B to own and work through her infantile and adult traumatic experiences. The process of transformation of traumatic traces lacking psychic representation, which was undertaken by both members of the analytic couple from the beginning of the treatment, was eventually approached in a particular way on the basis of their respective creative capacities, which facilitated the patient's psychic progress towards representability and the possibility of working through the experiences of the past. Much of the challenge of this case involved the analyst's capacity to maintain and at the same time consolidate her analytic posture within her internal setting, while doing her best to overcome any possible misfit (Balint, 1968) between her own technique and the specific complexities of the individual patient. The account illustrates the alternation of phases, at the beginning of the analysis, of remembering and interpretation on the one hand and of the representational void and construction on the other. In the case history proper and in her detailed summing up, the author refers to the place of the analyst during the analytic process, the involvement of her psychic functioning, and the importance of her capacity to work on and make use of her countertransference and self-analytic introspection, with a view to neutralizing any influence that aspects of her 'real person' might have had on the analytic field and on the complex processes taking place within it.